Organization Active NPI

Tallahassee Facility Operations LLC

Doing business as Tallahassee Living Center

  • Skilled Nursing Facility
  • Tallahassee, FL
National Provider Identifier
1528081403
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF1019096 Issued in FL
Legal business name
TALLAHASSEE FACILITY OPERATIONS LLC
Doing business as
Tallahassee Living Center
Practice address
1650 Phillips Rd
Tallahassee, FL 32308-5304
Phone
(850) 942-9868
Fax
(850) 942-1074
NPI assigned
Jul 25, 2006
Last updated
Dec 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Authorized official

Name
Kenneth Ussery
Title
VP
Phone
(407) 571-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF1019096 FL Primary

Addresses

Primary practice location

1650 Phillips Rd
Tallahassee, FL 32308-5304

Mailing address

1650 Phillips Rd
Tallahassee, FL 32308-5304
Phone (850) 942-9868

Other identifiers 1

IdentifierTypeStateIssuer
008042800MedicaidFL

Other names 1

  • Tallahassee Living Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other Consulate Healthcare

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1528081403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 PHILLIPS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085304",
            "telephone_number": "850-942-9868",
            "fax_number": "850-942-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 PHILLIPS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085304",
            "telephone_number": "850-942-9868",
            "fax_number": "850-942-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAHASSEE FACILITY OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "USSERY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1019096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008042800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Healthcare",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 Concourse Pkwy S Ste 200",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tallahassee Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.