KSMS Clearview Lantern, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2096R Issued in OH

Legal business name

KSMS CLEARVIEW LANTERN, LLC

Practice address

596 Champion Ave W
Warren, OH 44483-1312

Phone

(330) 847-6800

NPI assigned

Mar 26, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Brad Wood

Title

Chief Operating Officer

Phone

(317) 280-8455

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1669899746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 CHAMPION AVE W",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831312",
            "telephone_number": "330-847-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 CHAMPION AVE W",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831312",
            "telephone_number": "330-847-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KSMS CLEARVIEW LANTERN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "317-280-8455",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2096R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth A Krempasky, LPN
• Alexandria Kriech
• Matthew Krinock, DO
• Indira Krishnarao, M.D.
• Elaine Kroehle
• Dustin Kubacka, CDCA
• Kaicee Kubicina, LPCC
• Kourtney N Kubicina, LPC
• Debrah Anne Kulusich, MSED,LPC
• David H. Kupferberg, MD

• Assisted Living Facility in Warren, OH
• Providers in Warren, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.