Willow Knoll Retirement Community

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WILLOW KNOLL RETIREMENT COMMUNITY

Practice address

4400 Vannest Ave
Middletown, OH 45042-2770

Phone

(513) 422-5600

Fax

(513) 422-6532

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. David Lenkensdofer

Title

Cfo

Phone

(765) 759-0230

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1245375591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 VANNEST AVE",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450422770",
            "telephone_number": "513-422-5600",
            "fax_number": "513-422-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 VANNEST AVE",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450422770",
            "telephone_number": "513-422-5600",
            "fax_number": "513-422-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW KNOLL RETIREMENT COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "LENKENSDOFER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "765-759-0230",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2533708",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd Williams, CASE MANAGER, QMHS
• Whitney Jenell Williams, LPN
• Jennifer Willis, PTA
• Lisa Marie Willis
• Teresia Willis
• Peter Michael Wills, D.D.S.
• Bethany Wilson-Paul, LISW
• Molly Christine Wilson
• Sara G Winship
• Angelique Sherell Winston, LISW-S

• Skilled Nursing Facility in Middletown, OH
• Providers in Middletown, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.