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Organization Active NPI

Lorraine Assisted Care Dba Melissa Ann Bongart

Doing business as Melissa Ann Bongart

  • Adult Care Home Facility
  • Bradenton, FL
National Provider Identifier
1609117621
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
6906389 Issued in FL
Legal business name
LORRAINE ASSISTED CARE DBA MELISSA ANN BONGART
Doing business as
Melissa Ann Bongart
Practice address
5916 Lorraine Rd
Bradenton, FL 34211-9208
Phone
(941) 504-9412
NPI assigned
Mar 15, 2013
Last updated
Mar 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Authorized official

Name
Melissa Ann Bongart
Title
Owner
Phone
(941) 504-9412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 6906389 FL Primary

Addresses

Primary practice location

5916 Lorraine Rd
Bradenton, FL 34211-9208

Mailing address

5916 Lorraine Road
Bradenton, FL 34211
Phone (941) 504-9412

Other identifiers 1

IdentifierTypeStateIssuer
004043700MedicaidFL

Other names 1

  • Melissa Ann Bongart Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lorraine Assisted Care Dba Melissa Ann Bongart3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1609117621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 LORRAINE ROAD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34211",
            "telephone_number": "941-504-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5916 LORRAINE RD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119208",
            "telephone_number": "941-504-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORRAINE ASSISTED CARE DBA MELISSA ANN BONGART",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-15",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "BONGART",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-504-9412"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004043700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melissa Ann Bongart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.