C. Diederick Van Der Velde

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

C. DIEDERICK VAN DER VELDE

Doing business as

The Woodlands of Middletown, LLC

Practice address

3000 McGee Ave
Middletown, OH 45044-4991

Phone

(513) 423-2322

NPI assigned

Jul 27, 2012

Last updated

Jul 27, 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

Mr. Diederick Van Der Velde

Title

Sole Owner

Phone

(502) 500-7798

Specialties & licenses 1

Addresses

Other names 1

• The Woodlands of Middletown, LLC Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343347200000",
    "number": "1457607459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MCGEE AVE",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450444991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MCGEE AVE",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450444991",
            "telephone_number": "513-423-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. DIEDERICK VAN DER VELDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A",
        "authorized_official_last_name": "VAN DER VELDE",
        "authorized_official_first_name": "DIEDERICK",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "502-500-7798",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Woodlands of Middletown, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Butler County Community Health Consortium, Inc. (PHS Pharmacy Middletown)
• Daniel A Butler, M.D.
• Martina Byrd Slone
• Kelsey Byrd
• Jimmy Byun
• Clifford Quinn Cabansag, MD
• Jacqueline Marie Caldwell
• Kristen Caldwell, D.O.
• Ebony Danielle Calhoun, LPN
• Rebecca Renee Calhoun, LPN

• Assisted Living Facility in Middletown, OH
• Providers in Middletown, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.