Organization Active NPI

Pristine Senior Living of Cincinnati-Three Rivers, LLC

  • Skilled Nursing Facility
  • Cincinnati, OH
National Provider Identifier
1477938330
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRISTINE SENIOR LIVING OF CINCINNATI-THREE RIVERS, LLC
Practice address
7800 Jandaracres Dr
Cincinnati, OH 45248-2032
Phone
(513) 941-0787
NPI assigned
Jul 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Mr. Christopher T Cook
Title
Chief Executive Officer
Phone
(317) 408-8491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X OH Primary

Addresses

Primary practice location

7800 Jandaracres Dr
Cincinnati, OH 45248-2032

Mailing address

3301 W Purdue Ave
Muncie, IN 47304-6356
Phone (317) 408-8491

Other identifiers 1

IdentifierTypeStateIssuer
2744383MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1477938330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046356",
            "telephone_number": "317-408-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 JANDARACRES DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452482032",
            "telephone_number": "513-941-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE SENIOR LIVING OF CINCINNATI-THREE RIVERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "317-408-8491",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2744383",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.