NPIMap

Organization Active NPI

Park Ridge Nursing Home, Inc

Doing business as Park Ridge at Home

  • Home Health Agency
  • Rochester, NY
National Provider Identifier
1518015841
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PARK RIDGE NURSING HOME, INC
Doing business as
Park Ridge at Home
Practice address
89 Genesee St
Rochester, NY 14611-3201
Phone
(585) 368-6342
Fax
(585) 368-6395
NPI assigned
Jan 5, 2007
Last updated
Jan 14, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
PARK RIDGE NURSING HOME, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Authorized official

Name
Susan Bourne
Title
VP Home Andcommunity Based Services
Phone
(585) 368-6454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

89 Genesee St
Rochester, NY 14611-3201

Mailing address

89 Genesee St
Rochester, NY 14611-3201
Phone (585) 368-6342

Other identifiers 3

IdentifierTypeStateIssuer
01185955MedicaidNY
P0101059PROtherNYBLUE CHOICE
109058C1OtherNYPREFERRED CARE

Other names 1

  • Park Ridge at Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Garnetta M Ely10 organizations share this tax ID, including this one
Part of
Rochester Regional Health System Home Care

Other organizations with this tax ID 9

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": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1518015841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 GENESEE ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146113201",
            "telephone_number": "585-368-6342",
            "fax_number": "585-368-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 GENESEE ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146113201",
            "telephone_number": "585-368-6342",
            "fax_number": "585-368-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE NURSING HOME, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK RIDGE NURSING HOME, INC",
        "enumeration_date": "2007-01-05",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "BOURNE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "VP HOME ANDCOMMUNITY BASED SERVICES",
        "authorized_official_telephone_number": "585-368-6454"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01185955",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P0101059PR",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "109058C1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Ridge at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

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