Deaconess Long Term Care of Ohio, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5027 Issued in OH

Legal business name

DEACONESS LONG TERM CARE OF OHIO, INC.

Doing business as

Mason Health Care Center

Practice address

5640 Cox Smith Rd
Mason, OH 45040-2210

Phone

(513) 398-2881

Fax

(513) 398-2118

NPI assigned

Aug 26, 2005

Last updated

Jan 27, 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

John Murta

Title

Coo

Phone

(513) 559-2265

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Mason Health Care Center Doing business as

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1639162316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 901",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021459",
            "telephone_number": "513-487-3600",
            "fax_number": "513-475-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 COX SMITH RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450402210",
            "telephone_number": "513-398-2881",
            "fax_number": "513-398-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS LONG TERM CARE OF OHIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "MURTA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "513-559-2265"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "5285",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "5027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RES. CARE FACILITY LIC #",
            "identifier": "5285",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129140",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SNF LICENSE #",
            "identifier": "5027",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mason Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mason Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanessa L Davidson, PSY.D
• Gloria Jean Davis
• Gregory P. Davis, D.D.S.
• Jessica Dayton, CNP
• Jensen De Nijs, RRT
• Jennifer Dean, CNIM
• David Frederick Dearworth, M.D. (AND R.PH)
• Leslie Ann Deckter, M.D.
• Deerfield Township Family Counseling Center
• Deerfield TWP Family Counseling Center

• Skilled Nursing Facility in Mason, OH
• Providers in Mason, 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 Jan 27, 2020; 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.