Summerville at Ocala West, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9441 Issued in FL

Legal business name

SUMMERVILLE AT OCALA WEST, LLC

Doing business as

Brookdale Canopy Oaks

Practice address

9070 Southwest 80TH Avenue
Ocala, FL 34481

Phone

(352) 861-4444

Fax

(352) 861-4445

NPI assigned

May 23, 2007

Last updated

Jun 13, 2016By 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

Bryan Richardson

Title

Evp, Chief Admin. Officer

Phone

(615) 564-8131

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Brookdale Canopy Oaks Doing business as

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1437369857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST STE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145650",
            "telephone_number": "414-918-5000",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 SOUTHWEST 80TH AVENUE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34481",
            "telephone_number": "352-861-4444",
            "fax_number": "352-861-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT OCALA WEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EVP, CHIEF ADMIN. OFFICER",
        "authorized_official_telephone_number": "615-564-8131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9441",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "FL",
            "license": "AL9441",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078764-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Canopy Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mohamed Suliman, MD
• Toufeeq Suliman, MD
• Jaime Sullivan, LMT
• Tiffany Marie Summers
• Summerville at Ocala East, LLC (Brookdale Paddock Hills)
• Summerwood Home Health Services of District 3, LLC
• Summit Eye Care, PLLC
• Summit Medical Supply LLC
• Casey Monel Sumner, PHD
• Sumter & Marion Hearing, Inc. (Miracle Ear Hearing Center)

• Assisted Living Facility in Ocala, FL
• Providers in Ocala, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.