NPIMap

Organization Active NPI

Peregrine Health Services of Columbus LLC

Doing business as Summit's Trace Healthcare Center

  • Assisted Living Facility
  • Columbus, OH
National Provider Identifier
1508322546
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
PEREGRINE HEALTH SERVICES OF COLUMBUS LLC
Doing business as
Summit's Trace Healthcare Center
Practice address
935 N Cassady Ave
Columbus, OH 43219-2283
Phone
(614) 252-4987
NPI assigned
Feb 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Authorized official

Name
Timothy Dale Patton
Title
Cfo
Phone
(614) 459-2656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

935 N Cassady Ave
Columbus, OH 43219-2283

Mailing address

1661 Old Henderson Rd
Columbus, OH 43220-3644
Phone (614) 459-2656

Other names 1

  • SUMMIT'S TRACE HEALTHCARE CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Senior City2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1508322546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 OLD HENDERSON RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203644",
            "telephone_number": "614-459-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 N CASSADY AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432192283",
            "telephone_number": "614-252-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEREGRINE HEALTH SERVICES OF COLUMBUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-459-2656"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUMMIT'S TRACE HEALTHCARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.