Paddock View Residential Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

20041950A Issued in IN

Legal business name

PADDOCK VIEW RESIDENTIAL CENTER, INC.

Practice address

1700 E Bradford Pike
Marion, IN 46952-8643

Phone

(765) 664-7740

Fax

(765) 664-7743

NPI assigned

Jan 3, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Carol W. Boyle, MA

Title

Executive Director

Phone

(765) 664-7740

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Samantha Cook, MSW, LSCW

  • Clinical Social Worker
  • Peru, IN
  • NPI 1659049781
  NPD (past)
• Logan Douglass Wagner, LSW

  • Social Worker
  • Marion, IN
  • NPI 1558219378
  NPD (past)

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1396082863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E BRADFORD PIKE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469528643",
            "telephone_number": "765-664-7740",
            "fax_number": "765-664-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E BRADFORD PIKE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469528643",
            "telephone_number": "765-664-7740",
            "fax_number": "765-664-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PADDOCK VIEW RESIDENTIAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "765-664-7740",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "20041950A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscilla Ortega
• Orthopedic Specialists, Inc.
• Katrina C Ott, MSW, LCSW
• Stephanie N Owens
• Adewale Taiwo Oyeneye, MD
• Lizette Maria Padin-Martinez, DDS
• Audrey Elizabeth Page, RD, CD
• Megan Pakkala
• Allison Eliza Parker, MA, BCBA
• Jitendra I Patel, MD

• Community/Behavioral Health Agency in Marion, IN
• Providers in Marion, IN by specialty
• Community/Behavioral Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.