Five Rivers Assisted Living and Retirement Commmunity, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

FIVE RIVERS ASSISTED LIVING AND RETIREMENT COMMMUNITY, LLC

Doing business as

Five Reivers Assisted Living & Retirement Community

Practice address

3200 State Street
Suite 200
Salem, OR 97301

Phone

(503) 566-5715

Fax

(503) 588-3531

NPI assigned

May 9, 2007

Last updated

Oct 4, 2007By 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

Mr. Kelley D Hamilton

Title

Ceo-Pres of Manager

Phone

(503) 566-5715

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Five Reivers Assisted Living & Retirement Community Doing business as

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1649484759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 12TH ST",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971412637",
            "telephone_number": "503-842-0918",
            "fax_number": "503-842-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 STATE STREET",
            "address_2": "SUITE 200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-566-5715",
            "fax_number": "503-588-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE RIVERS ASSISTED LIVING AND RETIREMENT COMMMUNITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO-PRES OF MANAGER",
        "authorized_official_telephone_number": "503-566-5715",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTRY #",
            "identifier": "000394-95",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Five Reivers Assisted Living & Retirement Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Fithen
• Grace Anne Fitting, MD
• John E Fitzgerald, M.D.
• Kathleen Fitzpatrick, R.PH
• Five Red Car Day LLC (Happy Doc Family Medicine)
• Erin Fix, ND
• Aaron Flager
• Julie Flager, RDH
• Melinda R Flanagan, RDH
• Glynis Anne Flanigan, WHCNP

• Point of Service in Salem, OR
• Providers in Salem, OR by specialty
• Point of Service in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; 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.