Five Star Coral Springs LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1430095 Issued in FL

Legal business name

FIVE STAR CORAL SPRINGS LLC

Practice address

8500 Royal Palm Blvd
Coral Springs, FL 33065-5715

Phone

(954) 752-9500

Fax

(954) 755-9559

NPI assigned

Jun 5, 2006

Organization subpart

Yes

Parent organization

FIVE STAR CORAL SPRINGS LLCAs reported in NPPES

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

Authorized official

Name

Katherine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park Summit at Coral Springs Doing business as

Part of

Five Star Coral Springs LLC

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1245279256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 ROYAL PALM BLVD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655715",
            "telephone_number": "954-752-9500",
            "fax_number": "954-755-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 ROYAL PALM BLVD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655715",
            "telephone_number": "954-752-9500",
            "fax_number": "954-755-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR CORAL SPRINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR CORAL SPRINGS LLC",
        "enumeration_date": "2006-06-05",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1430095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001806600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Summit at Coral Springs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park Summit at Coral Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.