NPIMap

Organization Active NPI

Emeritus Properties V Inc

  • Assisted Living Facility
  • Orange Park, FL
National Provider Identifier
1508074733
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL9423 Issued in FL
Legal business name
EMERITUS PROPERTIES V INC
Practice address
1248 Kingsley Ave
Orange Park, FL 32073-4699
Phone
(904) 264-0207
Fax
(904) 264-9155
NPI assigned
May 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Authorized official

Name
Bryan Richardson
Title
Evp, Chief Admin. Officer
Phone
(615) 564-8131

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL9423 FL Primary
Alzheimer Center (Dementia Center) 311500000X AL9423 FL

Addresses

Primary practice location

1248 Kingsley Ave
Orange Park, FL 32073-4699

Mailing address

6737 W Washington St
Suite 2300
Milwaukee, WI 53214-5647

Other identifiers 1

IdentifierTypeStateIssuer
0097793-00MedicaidFL

Other names 1

  • Brookdale Orange Park Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Emeritus Properties NGH LLC236 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463097600000",
    "number": "1508074733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734699",
            "telephone_number": "904-264-0207",
            "fax_number": "904-264-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITUS PROPERTIES V INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-20",
        "last_updated": "2016-05-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EVP, CHIEF ADMIN. OFFICER",
        "authorized_official_telephone_number": "615-564-8131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9423",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "FL",
            "license": "AL9423",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097793-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Orange Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.