NPIMap

Organization Active NPI

Liberty Nursing Center Willard

Doing business as Hillside Acres

  • Skilled Nursing Facility
  • Willard, OH
National Provider Identifier
1366504375
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LIBERTY NURSING CENTER WILLARD
Doing business as
Hillside Acres
Practice address
370 E Howard
Willard, OH 44890
Phone
(419) 935-0148
Fax
(419) 933-6448
NPI assigned
Dec 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Kimberly Crisp, RNNPI 1689736696
Title
RN
Phone
(419) 935-0148

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

370 E Howard
Willard, OH 44890

Mailing address

370 E Howard St
Willard, OH 44890
Phone (419) 935-0148

Other identifiers 1

IdentifierTypeStateIssuer
2245010MedicaidOH

Other names 1

  • Hillside Acres Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366504375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 E HOWARD ST",
            "city": "WILLARD",
            "state": "OH",
            "postal_code": "44890",
            "telephone_number": "419-935-0148",
            "fax_number": "419-933-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 E HOWARD",
            "city": "WILLARD",
            "state": "OH",
            "postal_code": "44890",
            "telephone_number": "419-935-0148",
            "fax_number": "419-933-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY NURSING CENTER WILLARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRISP",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "419-935-0148",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2245010",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillside Acres",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.