Paul Hermitage Operator LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PAUL HERMITAGE OPERATOR LLC

Practice address

501 N 17TH Ave
Beech Grove, IN 46107-1169

Phone

(317) 786-2261

NPI assigned

Jan 31, 2023

Last updated

Jan 31, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

PAUL HERMITAGE OPERATOR LLCAs reported in NPPES

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

Authorized official

Name

David Cheplowitz

Title

Manager

Phone

(773) 272-2568

Specialties & licenses 1

Addresses

Part of

Paul Hermitage Operator LLC

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1396451597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 E VETERANS HWY",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085275090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N 17TH AVE",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "461071169",
            "telephone_number": "317-786-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL HERMITAGE OPERATOR LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAUL HERMITAGE OPERATOR LLC",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "CHEPLOWITZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-272-2568"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.