Country Charm

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COUNTRY CHARM

Practice address

3177 Meridian Parke Dr
Greenwood, IN 46142-9629

Phone

(317) 882-5455

Fax

(317) 882-3606

NPI assigned

Mar 18, 2008

Organization subpart

No

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

Authorized official

Name

Mr. C Diederick Van Der Velde

Title

Owner

Phone

(317) 882-5455

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1285805275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3177 MERIDIAN PARKE DR",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461429629",
            "telephone_number": "317-882-5455",
            "fax_number": "317-882-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3177 MERIDIAN PARKE DR",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461429629",
            "telephone_number": "317-882-5455",
            "fax_number": "317-882-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CHARM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "VAN DER VELDE",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "DIEDERICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-882-5455",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Coryea
• Zoe Coryell
• Jon Cotherman, MS/CCC-SLP
• Anthony Couch
• Jacquline Couch
• Olivia Marie Countryman, PA-C
• Jordon Courtney, FNP-C
• Jacqueline Suzanne Cowan, OTR
• David T Cox, MD
• Drucilla Kathleen Cox

• Assisted Living Facility in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.