NPIMap

Organization Active NPI

Emeritus Properties Xiv, LLC

  • Assisted Living Facility
  • Auburn, MA
National Provider Identifier
1295936813
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EMERITUS PROPERTIES XIV, LLC
Practice address
669 Washington Street
Auburn, MA 01501
Phone
(508) 832-4458
Fax
(508) 832-2861
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Authorized official

Name
Bryan Richardson
Title
Evp, Chief Admin. Officer
Phone
(615) 564-8131

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X EOEA CERTIFICATE ALF MA
Assisted Living Facility 310400000X MA Primary

Addresses

Primary practice location

669 Washington Street
Auburn, MA 01501

Mailing address

6737 W Washington St, Suite 2300
Milwaukee, WI 53214-5650
Phone (414) 918-5000

Other identifiers 2

IdentifierTypeStateIssuer
1905941MedicaidMA
1900455MedicaidMA

Other names 1

  • Brookdale Eddy Pond West Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2222275Brookdale Eddy Pond West669 Washington Street, Auburn, MA 01501Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Emeritus Properties NGH LLC236 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1295936813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST, SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145650",
            "telephone_number": "414-918-5000",
            "fax_number": "508-832-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 WASHINGTON STREET",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "01501",
            "telephone_number": "508-832-4458",
            "fax_number": "508-832-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITUS PROPERTIES XIV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EVP, CHIEF ADMIN. OFFICER",
        "authorized_official_telephone_number": "615-564-8131"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MA",
            "license": "EOEA CERTIFICATE ALF",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1905941",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1900455",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Eddy Pond West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.