FMG Clare Avenue Washington LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG CLARE AVENUE WASHINGTON LLC

Practice address

2701 Clare Ave
Bremerton, WA 98310-3313

Phone

(360) 377-3951

Fax

(360) 377-5443

NPI assigned

Dec 18, 2014

Organization subpart

No

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

Authorized official

Name

David C. Keating

Title

Agent

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510012800000",
    "number": "1245638543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 WEST LEMON STREET",
            "address_2": "C/O FOCUS MANAGEMENT GROUP",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091103",
            "telephone_number": "813-281-0062",
            "fax_number": "813-281-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CLARE AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103313",
            "telephone_number": "360-377-3951",
            "fax_number": "360-377-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG CLARE AVENUE WASHINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2017-11-07",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.