NPIMap

Organization Active NPI

Bishop Grady Villas

  • Assisted Living Facility
  • Saint Cloud, FL
National Provider Identifier
1558545475
Registry record updated Mar 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10398 Issued in FL
Legal business name
BISHOP GRADY VILLAS
Practice address
401 Bishop Grady CT
Saint Cloud, FL 34769-1538
Phone
(407) 892-6078
Fax
(407) 892-8081
NPI assigned
Dec 27, 2007
Last updated
Mar 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2014

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

Authorized official

Name
Mr. Kevin Charles Johnson
Title
Executive Director
Phone
(407) 892-6078

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU
Assisted Living Facility 310400000X AL10398 FL Primary
Private Vehicle 347C00000X NU

Addresses

Primary practice location

401 Bishop Grady CT
Saint Cloud, FL 34769-1538

Mailing address

401 Bishop Grady CT
Saint Cloud, FL 34769-1538
Phone (407) 892-6078

Other identifiers 3

IdentifierTypeStateIssuer
142955800MedicaidFL
692217198MedicaidFL
692217196MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393632000000",
    "number": "1558545475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BISHOP GRADY CT",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347691538",
            "telephone_number": "407-892-6078",
            "fax_number": "407-892-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BISHOP GRADY CT",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347691538",
            "telephone_number": "407-892-6078",
            "fax_number": "407-892-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISHOP GRADY VILLAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2014-03-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "407-892-6078",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10398",
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142955800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692217198",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692217196",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.