Elm Creek of IHS, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

1769N Issued in OH

Legal business name

ELM CREEK OF IHS, INC.

Practice address

115 Elmwood Cir
West Carrollton, OH 45449-2428

Phone

(305) 892-1790

Fax

(305) 538-2699

NPI assigned

May 11, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Theodore M. Duay III, CPA

Title

Cfo

Phone

(305) 892-1790

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• West Carrollton at Elm Creek Other name

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396950515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 MICHIGAN AVE",
            "address_2": "SUITE 736",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392538",
            "telephone_number": "305-892-1790",
            "fax_number": "305-538-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ELMWOOD CIR",
            "city": "WEST CARROLLTON",
            "state": "OH",
            "postal_code": "454492428",
            "telephone_number": "305-892-1790",
            "fax_number": "305-538-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELM CREEK OF IHS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUAY",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "305-892-1790",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OH",
            "license": "1769N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0513000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Carrollton at Elm Creek",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia Ann Dever
• Christopher Michael Dunfee
• Lindsey Cheyenne Eddington, RBT
• Jamie Lynn Edwards, B.S.
• Lisa J Edwards, LSW
• Elmwood Health & Rehab Center, LLC
• Melissa Ann Engle
• Angela Enix, RN
• Erica Enriquez
• Yesenia Esmeralda Enriquez

• Nursing Facility/Intermediate Care Facility in West Carrollton, OH
• Providers in West Carrollton, OH by specialty
• Nursing Facility/Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.