Glenmoor Opco Ventures, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GLENMOOR OPCO VENTURES, LLC

Practice address

230 Towerview Drive
Saint Augustine, FL 32092-2789

Phone

(515) 875-4500

Fax

(515) 875-4780

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judi L Buxo

Title

Assistant Corporate Secretary

Phone

(515) 875-4500

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1609322312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 TOWERVIEW DRIVE",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320922789",
            "telephone_number": "515-875-4500",
            "fax_number": "515-875-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 TOWERVIEW DRIVE",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320922789",
            "telephone_number": "515-875-4500",
            "fax_number": "515-875-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENMOOR OPCO VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "BUXO",
        "authorized_official_first_name": "JUDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ASSISTANT CORPORATE SECRETARY",
        "authorized_official_telephone_number": "515-875-4500"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "1030471020",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jax Gibson, PHARMD
• Austin Jeffrey Gillette, DO
• Christopher Robert Gilrain, PT, DPT, OTR/L
• Erica Givens, LMHC
• Karisa Glassmoyer
• William James Glenos II, D.M.D.
• Global Health Records, Inc.
• Sarah Glod
• Gloria Jean Lelaidier
• Gloria Z. Moore D.C., P.a.

• Skilled Nursing Facility in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.