Five Star Tucson Forum LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI419 Issued in AZ

Legal business name

FIVE STAR TUCSON FORUM LLC

Doing business as

The Health Care Center At The Forum At Tucson

Practice address

2500 N Rosemont Blvd
Tucson, AZ 85712-2167

Phone

(520) 325-4800

Fax

(520) 319-4076

NPI assigned

May 19, 2006

Organization subpart

Yes

Parent organization

FIVE STAR TUCSON FORUM LLCAs reported in NPPES

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

Authorized official

Name

Katherine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 1

Addresses

Other names 1

• The Health Care Center At The Forum At Tucson Doing business as

Part of

Five Star Tucson Forum LLC

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1457304404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N ROSEMONT BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122167",
            "telephone_number": "520-325-4800",
            "fax_number": "520-319-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N ROSEMONT BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122167",
            "telephone_number": "520-325-4800",
            "fax_number": "520-319-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR TUCSON FORUM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR TUCSON FORUM LLC",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Health Care Center At The Forum At Tucson",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Health Care Center At The Forum At Tucson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zachary Fitzgerald
• David Fitzmaurice, D.C.
• Leslie Diane Fitzpatrick, APRN-RNP
• Georgia Christine Fitzsimmons
• Five Star Rehabilitation and Wellness Services, LLC (Ageility Physical Therapy Solutions at Sierra Del Sol)
• Gerard Flacke, MD
• Lila Flagler, N.M.D.
• Samuel Flagler, N.M.D.
• Elizabeth Flaherty
• William Jordan Flake, DO

• Skilled Nursing Facility in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.