NPIMap

Organization Active NPI

Genesis

  • Skilled Nursing Facility
  • Salem, OH
National Provider Identifier
1659683936
Registry record updated Jul 2, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1087 Issued in OH
Legal business name
GENESIS
Practice address
2511 Bentley Dr
Salem, OH 44460-2503
Phone
(330) 337-3015
NPI assigned
Jul 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Authorized official

Name
Mrs. Shirley Ann Tice, COTA/L
Title
Certified Occupational Therapis
Phone
(330) 424-1504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1087 OH Primary

Addresses

Primary practice location

2511 Bentley Dr
Salem, OH 44460-2503

Mailing address

44755 Middle Beaver Rd
Lisbon, OH 44432-9556
Phone (330) 424-1504

National Provider Directory

National Provider Directory
Tax ID family
Genesis3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1659683936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44755 MIDDLE BEAVER RD",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444329556",
            "telephone_number": "330-424-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 BENTLEY DR",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444602503",
            "telephone_number": "330-337-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-02",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "TICE",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CERTIFIED OCCUPATIONAL THERAPIS",
        "authorized_official_telephone_number": "330-424-1504",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.