NPIMap

Organization Active NPI

Plymouth Court SNF, LLC

  • Skilled Nursing Facility
  • Plymouth, MI
National Provider Identifier
1447749080
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PLYMOUTH COURT SNF, LLC
Practice address
105 N Haggerty Rd
Plymouth, MI 48170
Phone
(734) 455-0510
NPI assigned
May 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Yair Zuckerman
Title
Manager
Phone
(773) 517-4777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

105 N Haggerty Rd
Plymouth, MI 48170

Mailing address

620 Davis St Ste 200
Evanston, IL 60201-4419
Phone (312) 590-1055

Other names 2

  • Illuminate HC Plymouth Doing business as
  • SKLD Plymouth Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1447749080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 DAVIS ST STE 200",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014419",
            "telephone_number": "312-590-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N HAGGERTY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "48170",
            "telephone_number": "734-455-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH COURT SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "ZUCKERMAN",
        "authorized_official_first_name": "YAIR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-517-4777"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illuminate HC Plymouth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SKLD Plymouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.