Reagan Park Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

140132642 Issued in IN

Legal business name

REAGAN PARK SENIOR LIVING LLC

Practice address

1176 Kingwood Dr
Avon, IN 46123-5501

Phone

(317) 271-0100

NPI assigned

Oct 15, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Kim Schmidt

Title

Health Facility Administrator

Phone

(317) 271-0100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1619371986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 KINGWOOD DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461235501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 KINGWOOD DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461235501",
            "telephone_number": "317-271-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAGAN PARK SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "HEALTH FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "317-271-0100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IN",
            "license": "140132642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Lauren Raghav, EDS
• Jocelyn Michelle Raine
• Jonathan Louis Rall, DC
• Casey N Randolph, CRNA
• Amber Leigh Ray, RDN, IFNCP
• Rebecca J de la Rosa, D.D.S., P.C. (Avon Family Dentistry)
• Rebuilding & Evolving Families LLC
• Deborah Redd, MD
• Bhasker Reddy, MD
• Rebecca Hillery Reese

• Assisted Living Facility in Avon, IN
• Providers in Avon, 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 15, 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.