Greene County

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

GREENE COUNTY

Doing business as

Greenewood Manor

Practice address

711 Dayton Xenia Rd
Xenia, OH 45385-2607

Phone

(937) 562-7550

Fax

(937) 562-7593

NPI assigned

Dec 28, 2005

Last updated

Dec 21, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Denise R Percival, LNHA

Title

Nursing Home Administrator

Phone

(937) 562-7550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GREENEWOOD MANOR Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Greene County

  dba Greene County Public Health

  • Public Health or Welfare Agency
  • Xenia, OH
  • NPI 1831234962

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1245217678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 DAYTON XENIA RD",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852607",
            "telephone_number": "937-562-7550",
            "fax_number": "937-562-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 DAYTON XENIA RD",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852607",
            "telephone_number": "937-562-7550",
            "fax_number": "937-562-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "PERCIVAL",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "NURSING HOME ADMINISTRATOR",
        "authorized_official_telephone_number": "937-562-7550",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0342025",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREENEWOOD MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Gradias
• Shannon L Graham
• Matthew Gravely, CDCA
• Kristen Gravitt, CDCA
• Amanda Green
• Greene County (Today Center for Adults)
• Greene County (Greene County Public Health)
• Greene County Board of MRDD
• Greene County Eye Care, Inc.
• Greene County Juvenile Court

• Nursing Facility/Intermediate Care Facility in Xenia, OH
• Providers in Xenia, OH by specialty
• Nursing Facility/Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.