SNH Indy Tenant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SNH INDY TENANT LLC

Doing business as

Meadowood Health Pavilion

Practice address

2455 N Tamarack TRL
Bloomington, IN 47408-1294

Phone

(812) 336-7060

Fax

(812) 333-8917

NPI assigned

Jul 29, 2019

Organization subpart

Yes

Parent organization

SNH INDY TENANT LLCAs reported in NPPES

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

Authorized official

Name

Jennifer F. Mintzer

Title

President & Chief Operating Officer

Phone

(617) 796-8350

Specialties & licenses 2

Addresses

Other names 1

• Meadowood Health Pavilion Doing business as

Part of

SNH Indy Tenant LLC

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1528612546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 300",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581634",
            "telephone_number": "617-796-8350",
            "fax_number": "617-796-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 N TAMARACK TRL",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474081294",
            "telephone_number": "812-336-7060",
            "fax_number": "812-333-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH INDY TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH INDY TENANT LLC",
        "enumeration_date": "2019-07-29",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "MINTZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadowood Health Pavilion",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meadowood Health Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Daniel Smithers, M.D.
• Susan Kaye Smitley, NP
• Jordan Scott Smuts, ATC
• Jenna Lyn Smyers, CCC-SLP
• Gretchen Snethen, CTRS
• Wade Nicholas Snider, LCSW
• Kendall Snodgrass
• Cathy Ann Snyder, M.D.
• Kristin Snyder, LMHC, PMH-C
• Julie Soddy-Gamblin, CMT

• Assisted Living Facility in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.