Dycora Transitional Health - Bloomington LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DYCORA TRANSITIONAL HEALTH - BLOOMINGTON LLC

Practice address

155 E Burks Dr
Bloomington, IN 47401-8459

Phone

(812) 332-4437

NPI assigned

Nov 23, 2016

Organization subpart

No

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

Authorized official

Name

Mary Hawkins

Title

Executive

Phone

(812) 332-4437

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1578006557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E BURKS DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018459",
            "telephone_number": "812-332-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E BURKS DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018459",
            "telephone_number": "812-332-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYCORA TRANSITIONAL HEALTH - BLOOMINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-23",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE",
        "authorized_official_telephone_number": "812-332-4437"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan Liviu Dusleag, MD
• Tammy Dutkowski
• Tabitha Brooke Duvall
• David A Dwyer, M.D.
• Mary E Dy, OD
• Margaret Mirch Dyer, CPNP
• Kenneth Luke Eades, DDS
• Katherine Eads
• Samantha Eads, FNP
• Samantha Anne Eads, RN

• Skilled Nursing Facility in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Skilled Nursing Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.