FS Tenant Pool I Trust

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1099 Issued in DE

Legal business name

FS TENANT POOL I TRUST

Practice address

255 Possum Park Rd
Newark, DE 19711-3877

Phone

(302) 366-0160

Fax

(302) 366-7634

NPI assigned

May 26, 2006

Organization subpart

Yes

Parent organization

FS TENANT POOL I TRUSTAs reported in NPPES

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

Authorized official

Name

Kathrine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Millcroft Retirement Community Doing business as

Part of

FS Tenant Pool I Trust

Locations

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1366498719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 POSSUM PARK RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197113877",
            "telephone_number": "302-366-0160",
            "fax_number": "302-366-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 POSSUM PARK RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197113877",
            "telephone_number": "302-366-0160",
            "fax_number": "302-366-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FS TENANT POOL I TRUST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FS  TENANT POOL I TRUST",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHRINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "DE",
            "license": "1307",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "DE",
            "license": "1099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001188711",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millcroft Retirement Community",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Millcroft Retirement Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andriana Frost, PSYD
• Christopher Frost, DPT
• Melissa Frost
• Kelsey Fryberger, FNP-C
• Tara Marie Frye, PA-C
• Gerard Fulda, MD
• Denise F Fuller, LCSW
• Susan Fullerton, MSN
• Joseph Fullum
• Samantha Fulton

• Skilled Nursing Facility in Newark, DE
• Providers in Newark, DE by specialty
• Skilled Nursing Facility in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.