CHS - Clermont NCC, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1307N Issued in OH

Legal business name

CHS - CLERMONT NCC, INC.

Practice address

934 State Route 28
Milford, OH 45150-1912

Phone

(513) 831-1770

Fax

(513) 831-5184

NPI assigned

Dec 1, 2005

Organization subpart

No

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

Authorized official

Name

Robert Speelman

Title

President

Phone

(330) 204-1040

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clermont Nursing Care Center Doing business as

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402531200000",
    "number": "1528042736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "782 W ORANGE RD",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430158922",
            "telephone_number": "330-204-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 STATE ROUTE 28",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451501912",
            "telephone_number": "513-831-1770",
            "fax_number": "513-831-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS - CLERMONT NCC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2014-06-12",
        "status": "A",
        "authorized_official_last_name": "SPEELMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-204-1040"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1307N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2515568",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clermont Nursing Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Milford, OH
• Providers in Milford, 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 Jun 12, 2014; 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.