American Eagle Health Care Services Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3608 Issued in OH

Legal business name

AMERICAN EAGLE HEALTH CARE SERVICES INC

Doing business as

Cardinal Woods Skilled Nursing & Rehab

Practice address

6831 Chapel Rd
Madison, OH 44057-2255

Phone

(440) 428-5103

Fax

(440) 428-9003

NPI assigned

Apr 3, 2006

Last updated

Apr 20, 2008By 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

Ms. Joyce M Humphrey, LNHA; RN

Title

Administrator

Phone

(440) 428-5103

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CARDINAL WOODS SKILLED NURSING & REHAB Doing business as

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1467414904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6831 CHAPEL RD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440572255",
            "telephone_number": "440-428-5103",
            "fax_number": "440-428-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6831 CHAPEL RD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440572255",
            "telephone_number": "440-428-5103",
            "fax_number": "440-428-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN EAGLE HEALTH CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HUMPHREY",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "440-428-5103",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LNHA; RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "3608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2397562",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARDINAL WOODS SKILLED NURSING & REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.