Swiss Village, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

120002801 Issued in IN

Legal business name

SWISS VILLAGE, INC.

Practice address

1350 W Main St
Berne, IN 46711-1741

Phone

(260) 589-3173

Fax

(260) 589-8369

NPI assigned

Jul 22, 2005

Last updated

Aug 9, 2012By 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

Roger D Young

Title

Controller

Phone

(260) 589-3173

Specialties & licenses 5

Addresses

Other identifiers 1

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1427058288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 W MAIN ST",
            "city": "BERNE",
            "state": "IN",
            "postal_code": "467111741",
            "telephone_number": "260-589-3173",
            "fax_number": "260-589-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W MAIN ST",
            "city": "BERNE",
            "state": "IN",
            "postal_code": "467111741",
            "telephone_number": "260-589-3173",
            "fax_number": "260-589-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWISS VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "260-589-3173"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IN",
            "license": "120002801",
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "IN",
            "license": "120002801",
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "IN",
            "license": "120002801",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IN",
            "license": "120002801",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "120002801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100274540A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.