Premier Estates 524, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PREMIER ESTATES 524, LLC

Practice address

1500 Sherman Ave
Norwood, OH 45212-2510

Phone

(513) 631-6800

NPI assigned

Oct 26, 2017

Last updated

Feb 1, 2019By 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

Cassidy Bancroft

Title

Chief Accounting Officer

Phone

(941) 758-4745

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1629580956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085509",
            "telephone_number": "941-758-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SHERMAN AVE",
            "city": "NORWOOD",
            "state": "OH",
            "postal_code": "452122510",
            "telephone_number": "513-631-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ESTATES 524, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "BANCROFT",
        "authorized_official_first_name": "CASSIDY",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "941-758-4745"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0276640",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0250645",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orthopedic Diagnostic & Treatment Ctr Inc
• Stacy Clarence Osborne, DPM
• Joann Wilbers Payne, LISW
• Mary M. Phelan, OTR/L
• David Lee Potts, PHARM.D.
• Premier Estates 525, LLC
• Heather Marie Rammel, SWT
• Steven Reed, MD
• Laura Reinhold, OTR/L
• Marilyn Robertson, RN

• Skilled Nursing Facility in Norwood, OH
• Providers in Norwood, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.