Wickshire Fort Myers Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WICKSHIRE FORT MYERS OPCO LLC

Practice address

3501 Hancock Bridge Parkway
Fort Myers, FL 33903

Phone

(239) 217-5900

Fax

(239) 217-5960

NPI assigned

May 15, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Dan O'Keefe, JD

Title

Ceo

Phone

(615) 942-0240

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1621036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621036800000",
    "number": "1639743552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 OLD HICKORY BLVD",
            "address_2": "BUILDING ONE SUITE 125",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-942-0240",
            "fax_number": "615-806-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HANCOCK BRIDGE PARKWAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33903",
            "telephone_number": "239-217-5900",
            "fax_number": "239-217-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKSHIRE FORT MYERS OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-15",
        "last_updated": "2021-05-15",
        "certification_date": "2021-05-15",
        "status": "A",
        "authorized_official_last_name": "O'KEEFE",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-942-0240",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Fort Myers, FL
• Providers in Fort Myers, 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 May 15, 2021; 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.