NPIMap

Organization Active NPI

Blossom View Nursing Home, Inc.

  • Skilled Nursing Facility
  • Sodus, NY
National Provider Identifier
1366445074
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5828301N Issued in NY
Legal business name
BLOSSOM VIEW NURSING HOME, INC.
Practice address
6884 Maple Ave
Sodus, NY 14551-9303
Phone
(315) 483-9118
Fax
(315) 483-9432
NPI assigned
May 27, 2005
Last updated
Aug 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Authorized official

Name
Naomi Wentz
Title
Business Manager
Phone
(315) 483-9118

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 5828301N NY
Skilled Nursing Facility 314000000X 5828301N NY Primary

Addresses

Primary practice location

6884 Maple Ave
Sodus, NY 14551-9303

Mailing address

6884 Maple Ave
Sodus, NY 14551-9303
Phone (315) 483-9118

Other identifiers 2

IdentifierTypeStateIssuer
00997604MedicaidNY
5828301NOtherNYOPERATING CERTIFICATE #

National Provider Directory

National Provider Directory
Tax ID family
Blossom View Nursing Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1366445074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6884 MAPLE AVE",
            "city": "SODUS",
            "state": "NY",
            "postal_code": "145519303",
            "telephone_number": "315-483-9118",
            "fax_number": "315-483-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6884 MAPLE AVE",
            "city": "SODUS",
            "state": "NY",
            "postal_code": "145519303",
            "telephone_number": "315-483-9118",
            "fax_number": "315-483-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM VIEW NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "WENTZ",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "315-483-9118"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NY",
            "license": "5828301N",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5828301N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00997604",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING CERTIFICATE #",
            "identifier": "5828301N",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sodus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; 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.