Clermont1818 Opco, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CLERMONT1818 OPCO, LLC

Doing business as

Madison at Clermont

Practice address

650 E Minnehaha Ave
Clermont, FL 34711-3445

Phone

(352) 241-0844

NPI assigned

Jan 24, 2020

Last updated

Jan 24, 2020By 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

Joanne Grzybowski

Title

Controller

Phone

(706) 691-9308

Specialties & licenses 1

Addresses

Other names 1

• Madison at Clermont Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1629608013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E MINNEHAHA AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113445",
            "telephone_number": "352-241-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E MINNEHAHA AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113445",
            "telephone_number": "352-241-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLERMONT1818 OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "GRZYBOWSKI",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "706-691-9308"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison at Clermont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clermont Radiology LLC
• Clermont Smiles Dentistry, PA (Clermont Smiles Dentistry)
• Clermont SNF LLC
• Clermont Speech and Language Therapy Center, LLC
• Clermont Surgical Associates
• Celestine Clifford
• Hope Renee Clinard, MA, RMHCI
• CMB Health Incorporated
• Lindsey E Cobb, CCC-SLP
• Jessa Cobzac

• Assisted Living Facility in Clermont, FL
• Providers in Clermont, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.