NPIMap

Organization Active NPI

SHP III Heron Fort Myers, LLC

  • Assisted Living Facility
  • Fort Myers, FL
National Provider Identifier
1447459334
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
LICENSE PENDING Issued in FL
Legal business name
SHP III HERON FORT MYERS, LLC
Practice address
9731 Commerce Center CT
Fort Myers, FL 33908-1400
Phone
(239) 334-2500
NPI assigned
Jul 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
John Dark
Title
VP
Phone
(770) 395-8635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X LICENSE PENDING FL Primary

Addresses

Primary practice location

9731 Commerce Center CT
Fort Myers, FL 33908-1400

Mailing address

2 Ravinia Dr
Suite 400
Atlanta, GA 30346-2104

National Provider Directory

National Provider Directory
Tax ID family
Barrington Terrace2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2 Ravinia Dr
Ste 400
Atlanta, GA 30346

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1447459334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RAVINIA DR",
            "address_2": "SUITE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303462104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9731 COMMERCE CENTER CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339081400",
            "telephone_number": "239-334-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHP III HERON FORT MYERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "DARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "770-395-8635"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "LICENSE PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.