Brightstar Senior Living Operations of Fort Wayne, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BRIGHTSTAR SENIOR LIVING OPERATIONS OF FORT WAYNE, LLC

Practice address

11430 Coldwater Rd
Fort Wayne, IN 46845-1253

Phone

(260) 234-2929

NPI assigned

Oct 19, 2021

Organization subpart

Yes

Parent organization

BRIGHTSTAR GROUP HOLDINGS, INCAs reported in NPPES

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

Authorized official

Name

Lisa Kasper

Title

Compliance Paralegal

Phone

(847) 693-2003

Specialties & licenses 2

Addresses

Part of

Fairlawnbrightstar

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1639832405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 TRI STATE PKWY STE 700",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319177",
            "telephone_number": "224-419-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11430 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451253",
            "telephone_number": "260-234-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTSTAR SENIOR LIVING OPERATIONS OF FORT WAYNE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHTSTAR GROUP HOLDINGS, INC",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "KASPER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "COMPLIANCE PARALEGAL",
        "authorized_official_telephone_number": "847-693-2003"
    },
    "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": []
}

• Kristine Briggs-Connelly, MSPT
• William F. Brigham, OD
• Bright Beginnings1
• Bright Life ABA
• Bright Medical Caring in PC
• Baylianna Reese Brink
• John B Brinkman, MD
• John J Brinkman Jr., PH.D.
• Brooke Brinneman, COTA
• Rachel N Brinson

• Assisted Living Facility in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.