PGN Op Oak LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PGN OP OAK LLC

Doing business as

Oak Pavilion Nursing Center

Practice address

510 Oak St
Cincinnati, OH 45219-2507

Phone

(513) 751-0880

NPI assigned

Sep 4, 2020

Last updated

Sep 4, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Goldner

Title

Authorized Official

Phone

(732) 645-9800

Specialties & licenses 1

Addresses

Other names 1

• Oak Pavilion Nursing Center Doing business as

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1508470790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 CHESTNUT ST STE 102",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 OAK ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192507",
            "telephone_number": "513-751-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PGN OP OAK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "GOLDNER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "732-645-9800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Pavilion Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Pfizenmayer, PHARMD
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• Skilled Nursing Facility in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.