Organization Active NPI

Goodlettsville Al MC Care Properties, LLC

  • Assisted Living Facility
  • Goodlettsville, TN
National Provider Identifier
1467069807
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GOODLETTSVILLE AL MC CARE PROPERTIES, LLC
Practice address
322 Northcreek Blvd
Goodlettsville, TN 37072-1998
Phone
(615) 712-1180
NPI assigned
Sep 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Authorized official

Name
Gregory A Roderick
Title
Member
Phone
(503) 443-1818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

322 Northcreek Blvd
Goodlettsville, TN 37072-1998

Mailing address

7420 SW Bridgeport Rd Ste 105
Portland, OR 97224-7790
Phone (503) 597-4906

Other names 1

  • Jubilee Hills at Goodlettsville Doing business as

National Provider Directory

National Provider Directory

Locations

322 Northcreek Blvd
Goodlettsville, TN 37072
Phone (615) 712-1180

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1467069807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 SW BRIDGEPORT RD STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247790",
            "telephone_number": "503-597-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 NORTHCREEK BLVD",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721998",
            "telephone_number": "615-712-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODLETTSVILLE AL MC CARE PROPERTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-443-1818"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jubilee Hills at Goodlettsville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goodlettsville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.