Shady Palms Retirement Homes, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

6694 Issued in FL

Legal business name

SHADY PALMS RETIREMENT HOMES, INC.

Practice address

14527 N Florida Ave
Tampa, FL 33613-2134

Phone

(813) 961-3072

Fax

(813) 968-4713

NPI assigned

Jun 2, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Robert Scott Bennett, MBA

Title

Administrator

Phone

(813) 961-3072

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1366601759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14527 N FLORIDA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132134",
            "telephone_number": "813-961-3072",
            "fax_number": "813-968-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14527 N FLORIDA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132134",
            "telephone_number": "813-961-3072",
            "fax_number": "813-968-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY PALMS RETIREMENT HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-961-3072",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "6694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Shackelford, OT
• Margaret Shackelford
• Nathan Shadd
• Megan Elizabeth Shader, PHARM.D.
• Shady Oaks Living Center
• Kristy Marie Shaeer, PHARMD
• Claudia Shafer
• Andrea Theresia Shaffer, ARNP
• Claudia Shaffer, M.S., CCC-SLP
• Mary Jo Shaffer, OT

• Assisted Living Facility in Tampa, FL
• Providers in Tampa, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.