Potter'S House at Cannon Point, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10434 Issued in FL

Legal business name

POTTER'S HOUSE AT CANNON POINT, INC

Practice address

5820 5830 NW 27TH CT
Lauderhill, FL 33313-2330

Phone

(954) 733-3366

Fax

(954) 733-2993

NPI assigned

Oct 23, 2017

Organization subpart

No

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

Authorized official

Name

Patricia Buchanan

Title

Administrator

Phone

(954) 733-3366

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1477064095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 5830 NW 27TH CT",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333132330",
            "telephone_number": "954-733-3366",
            "fax_number": "954-733-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 5830 NW 27TH CT",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333132330",
            "telephone_number": "954-733-3366",
            "fax_number": "954-733-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTER'S HOUSE AT CANNON POINT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "BUCHANAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-733-3366"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002314100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Plummer
• Fanny Marcela Pombo Diaz, SLPA
• Ponkeys Home Care
• Claudette Porter, MSN, RN
• Lazara Portuondo
• Premier Care Group
• Premier Medical Center of Inverrary, Inc.
• Preventative Healthcare Management
• Pri-Med Walk in Clinic
• Prime Home Care LLC

• Assisted Living Facility in Lauderhill, FL
• Providers in Lauderhill, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.