WV-Rockport SNF Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WV-ROCKPORT SNF OPCO, LLC

Practice address

44 South St
Rockport, MA 01966-1800

Phone

(978) 546-6311

NPI assigned

Oct 5, 2016

Organization subpart

Yes

Parent organization

WACHUSETT VENTURES, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Raymond A. Dennehy III

Title

Principal

Phone

(978) 886-3336

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Den-Mar Health and Rehabilitation Center Doing business as

Part of

Wachusett Ventures LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wachusett Ventures LLC

  • Skilled Nursing Facility
  • Wellesley Hills, MA
  • NPI 1083065908
  NPPES parent name

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1639629439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WASHINGTON ST",
            "address_2": "SUITE 190",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024811900",
            "telephone_number": "781-943-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 SOUTH ST",
            "city": "ROCKPORT",
            "state": "MA",
            "postal_code": "019661800",
            "telephone_number": "978-546-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WV-ROCKPORT SNF OPCO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WACHUSETT VENTURES, LLC",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "DENNEHY",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "978-886-3336",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110100091A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Den-Mar Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Victoria Vanderburgh, NP
• Patricia Vesey-McGrew, NCPSYA
• Walgreen Co
• Sydney Melvin Wedmore, MD
• Keith Allen Wharton Jr., MD PHD

• Skilled Nursing Facility in Rockport, MA
• Providers in Rockport, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.