Beacon by the Bay LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10713 Issued in FL

Legal business name

BEACON BY THE BAY LLC

Practice address

141 Kaelyn LN
Port St Joe, FL 32456-6180

Phone

(850) 647-4000

Fax

(850) 647-4004

NPI assigned

Jun 30, 2011

Organization subpart

No

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

Authorized official

Name

Liza Rojas

Title

Manager

Phone

(850) 647-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BEACON VILLA RETIREMENT CENTER Other name

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1487941399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 KAELYN LN",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566180",
            "telephone_number": "850-647-4000",
            "fax_number": "850-647-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 KAELYN LN",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566180",
            "telephone_number": "850-647-4000",
            "fax_number": "850-647-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BY THE BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "ROJAS",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "850-647-4000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000451700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEACON VILLA RETIREMENT CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ascension Sacred Heart Gulf
• Ascension Sacred Heart Gulf
• Kristie L Ash
• Ashten Mikaela Bailey, OTR/L
• Monica Barfield, ARNP
• Beacon Villa Alf Operating LLC
• Brittany Jade Beauchamp, APRN
• Ellen Berkowitz, MD
• Rachel Marie Bixler, M.D.
• Board of County Commissioners Gulf County

• Assisted Living Facility in Port St Joe, FL
• Providers in Port St Joe, 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 Jun 30, 2011; 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.