The Waters of Yorktown, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THE WATERS OF YORKTOWN, LLC

Practice address

2000 S. Andrews Road
Yorktown, IN 47396-6812

Phone

(765) 759-7740

Fax

(765) 759-7131

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Alan Sorscher

Title

Cfo

Phone

(708) 449-1900

Specialties & licenses 2

Addresses

Other identifiers 6

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1275572646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 FENCL LANE",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601622067",
            "telephone_number": "708-449-1900",
            "fax_number": "708-449-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S. ANDREWS ROAD",
            "city": "YORKTOWN",
            "state": "IN",
            "postal_code": "473966812",
            "telephone_number": "765-759-7740",
            "fax_number": "765-759-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATERS OF YORKTOWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "SORSCHER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "708-449-1900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "05-000143-1",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100283890C",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ST",
            "identifier": "000000391196",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000381429",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OT",
            "identifier": "000000391199",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC REGION B SUPPLIER#",
            "identifier": "5584850001",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PT",
            "identifier": "000000391198",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Yorktown, IN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.