PGN Op Echo LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PGN OP ECHO LLC

Doing business as

Echo Manor Extended Care Center

Practice address

10270 Blacklick Eastern Rd
Pickerington, OH 43147-9225

Phone

(614) 864-1718

NPI assigned

Sep 4, 2020

Organization subpart

No

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

Authorized official

Name

Samuel Goldner

Title

Authorized Official

Phone

(732) 645-9800

Specialties & licenses 1

Addresses

Other names 1

• Echo Manor Extended Care Center Doing business as

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1245844430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 CHESTNUT ST STE 102",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10270 BLACKLICK EASTERN RD",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431479225",
            "telephone_number": "614-864-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PGN OP ECHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "GOLDNER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "732-645-9800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Echo Manor Extended Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caprice Renee Peter, LPN
• Dylan Ray Peterman
• Myracle Peterson
• Sydney Marie Peterson
• Stella Petroff, DMD
• Robert Ngoc Pham, D.D.S., M.S.
• Phillip D Katz DDS
• Domini Phillips-Perkins
• Pick Health & Performance LLC
• Pick-Me LTD

• Skilled Nursing Facility in Pickerington, OH
• Providers in Pickerington, 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 Sep 4, 2020; 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.