City of Marianna Office of City Clerk

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1322096 Issued in FL

Legal business name

CITY OF MARIANNA OFFICE OF CITY CLERK

Practice address

4295 5TH Ave
Marianna, FL 32446-2176

Phone

(850) 482-8091

Fax

(850) 482-6162

NPI assigned

Oct 24, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Melinda S. Gay, NHA

Title

Administrator

Phone

(850) 482-8091

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marianna Health and Rehabilitation Center Former legal business name

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1376533174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4295 5TH AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462176",
            "telephone_number": "850-482-8091",
            "fax_number": "850-482-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 5TH AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462176",
            "telephone_number": "850-482-8091",
            "fax_number": "850-482-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MARIANNA OFFICE OF CITY CLERK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-482-8091",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1322096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020347500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marianna Health and Rehabilitation Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Marianna, FL
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.