Wickshire Deer Park Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WICKSHIRE DEER PARK OPCO LLC

Practice address

3801 East Galbraith Road
Cincinnati, OH 45236

Phone

(513) 443-6224

Fax

(513) 745-7616

NPI assigned

Jan 2, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Okeefe, JD

Title

Ceo

Phone

(615) 942-0240

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1467091868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 OLD HICKORY BLVD",
            "address_2": "BUILDING ONE SUITE 125",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-942-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 EAST GALBRAITH ROAD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45236",
            "telephone_number": "513-443-6224",
            "fax_number": "513-745-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKSHIRE DEER PARK OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "OKEEFE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-942-0240",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Nathanial Wickemeier
• Lisa Darlene Wickemeier
• Allen Wicken, P.T.
• Charles Wickenhofer, LSW
• Brodus Lee Wicks
• Matt Widanski, PHARMD
• Eleanor A Widdice, MD
• Michelle L Widecan, CNP
• Kristie Ann Wideen, COTA/L
• Jennifer Widener

• Assisted Living Facility in Cincinnati, OH
• Providers in Cincinnati, 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 Jan 2, 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.