NPIMap

Organization Active NPI

GV Lakeland, LLC

Doing business as Grand Villa of Lakeland

  • Assisted Living Facility
  • Lakeland, FL
National Provider Identifier
1457726838
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL 6107 Issued in FL
Legal business name
GV LAKELAND, LLC
Doing business as
Grand Villa of Lakeland
Practice address
2111 Lakeland Hills Blvd
Lakeland, FL 33805-2905
Phone
(836) 688-1126
Fax
(863) 683-3326
NPI assigned
Dec 10, 2015
Last updated
Dec 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Authorized official

Name
Johnny Sizemore
Title
Operations Coordinator
Phone
(727) 726-3980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL 6107 FL Primary

Addresses

Primary practice location

2111 Lakeland Hills Blvd
Lakeland, FL 33805-2905

Mailing address

13770 58TH St N
Suite 312
Clearwater, FL 33760-3759
Phone (727) 726-3980

Other names 1

  • Grand Villa of Lakeland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
GV Clearwater LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1457726838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13770 58TH ST N",
            "address_2": "SUITE 312",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603759",
            "telephone_number": "727-726-3980",
            "fax_number": "727-726-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052905",
            "telephone_number": "836-688-1126",
            "fax_number": "863-683-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GV LAKELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "SIZEMORE",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_title_or_position": "OPERATIONS COORDINATOR",
        "authorized_official_telephone_number": "727-726-3980"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL 6107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Villa of Lakeland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.