Woodland Manor Limited Partnership

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5012 Issued in OH

Legal business name

WOODLAND MANOR LIMITED PARTNERSHIP

Doing business as

Eaglewood Village Care Center

Practice address

2000 Villa Rd
Springfield, OH 45503-1761

Phone

(937) 399-7195

Fax

(937) 399-1474

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Joseph V Gulling, NHA

Title

Vice President, Agent for Woodland

Phone

(937) 399-7195

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eaglewood Village Care Center Doing business as

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1346374949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 VILLA RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031761",
            "telephone_number": "937-399-7195",
            "fax_number": "937-399-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 VILLA RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031761",
            "telephone_number": "937-399-7195",
            "fax_number": "937-399-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND MANOR LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "GULLING",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "VICE PRESIDENT, AGENT FOR WOODLAND",
        "authorized_official_telephone_number": "937-399-7195",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "5012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0628566",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eaglewood Village Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Thomas Wolf, O.D.
• Carrie Wolfe
• Ronald E Wollum III, PAC
• Kayla Wood
• Stacy Lynn Wood
• Woodland Manor Nursing, LLC (Eaglewood Care Center)
• Amanda Lynn Woodruff
• Angela Woods
• Deana Marie Woodward
• Thomas Melvin Woolery

• Skilled Nursing Facility in Springfield, OH
• Providers in Springfield, 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 Jul 1, 2011; 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.