Village at Marymount

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2463N Issued in OH

Legal business name

VILLAGE AT MARYMOUNT

Doing business as

Villa St. Joseph

Practice address

5200 Marymount Village Drive
Garfield Heights, OH 44125-2914

Phone

(216) 587-8627

NPI assigned

Nov 1, 2006

Last updated

Dec 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffry A. Myers, CPA

Title

C.O.O.

Phone

(216) 587-8627

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Villa St. Joseph Doing business as

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1346328994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 MARYMOUNT VILLAGE DRIVE",
            "city": "GARFIELD HTS.",
            "state": "OH",
            "postal_code": "44125",
            "telephone_number": "216-587-8627",
            "fax_number": "216-332-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 MARYMOUNT VILLAGE DRIVE",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252914",
            "telephone_number": "216-587-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE AT MARYMOUNT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "JEFFRY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "216-587-8627",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "2463N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2710749",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa St. Joseph",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Garfield Heights, OH
• Providers in Garfield Heights, 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 Dec 19, 2014; 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.