NPIMap

Organization Active NPI

Alcove Retirement Center III

  • Assisted Living Facility (Mental Illness)
  • St Petersburg, FL
National Provider Identifier
1386944064
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
AL6511 Issued in FL
Legal business name
ALCOVE RETIREMENT CENTER III
Practice address
2801 4TH St N
St Petersburg, FL 33704
Phone
(727) 898-0560
Fax
(727) 895-1155
NPI assigned
Oct 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Nelly McNulty
Title
Owner/Administrator
Phone
(727) 898-0560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X AL6511 FL Primary

Addresses

Primary practice location

2801 4TH St N
St Petersburg, FL 33704

Mailing address

2801 4TH St N
St Petersburg, FL 33704
Phone (727) 898-0560

Other identifiers 2

IdentifierTypeStateIssuer
140082700MedicaidFL
685933000MedicaidFL

Other names 1

  • Alcove Assisted Living Facility Other name

National Provider Directory

National Provider Directory

Locations

2801 4th St N
St Petersburg, FL 33704
Phone (727) 898-0560

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1386944064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33704",
            "telephone_number": "727-898-0560",
            "fax_number": "727-895-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33704",
            "telephone_number": "727-898-0560",
            "fax_number": "727-895-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALCOVE RETIREMENT CENTER III",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "NELLY",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "727-898-0560"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL6511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140082700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "685933000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alcove Assisted Living Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.