FKP Sun City Senior Living Tenant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9323 Issued in FL

Legal business name

FKP SUN CITY SENIOR LIVING TENANT LLC

Doing business as

Belvedere Commons of Sun City Center

Practice address

758 Cortaro Dr
Ruskin, FL 33573-6803

Phone

(813) 642-8400

Fax

(813) 642-0306

NPI assigned

Nov 12, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Jody Marie Boedigheimer

Title

S.V.P. Managing Agent

Phone

(763) 971-9273

Specialties & licenses 1

Addresses

Other names 1

• Belvedere Commons of Sun City Center Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1316377351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 CORTARO DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736803",
            "telephone_number": "813-642-8400",
            "fax_number": "813-642-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 CORTARO DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736803",
            "telephone_number": "813-642-8400",
            "fax_number": "813-642-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FKP SUN CITY SENIOR LIVING TENANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "BOEDIGHEIMER",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "S.V.P. MANAGING AGENT",
        "authorized_official_telephone_number": "763-971-9273",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Belvedere Commons of Sun City Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Ruskin, FL
• Providers in Ruskin, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.