Watermark Logan, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

127502 Issued in PA

Legal business name

WATERMARK LOGAN, LLC

Practice address

2 Franklin Town Blvd
Philadelphia, PA 19103-1238

Phone

(215) 563-1800

NPI assigned

Nov 8, 2016

Organization subpart

No

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

Authorized official

Name

Greta Frazier

Title

Director

Phone

(520) 797-4000

Specialties & licenses 1

Addresses

Other names 1

• The Springs at the Watermark Doing business as

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1679015697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W RUDASILL RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047800",
            "telephone_number": "520-797-4000",
            "fax_number": "520-797-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FRANKLIN TOWN BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031238",
            "telephone_number": "215-563-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERMARK LOGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "GRETA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "520-797-4000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "127502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Springs at the Watermark",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tatsuya Watanabe, MD, PHD
• Jessica Watari, DO
• Watchful Homecare Organization LLC
• Eric Waterford
• Watermark Logan Partners, L.P.
• Christal Waters-Porter
• Beverly Ann Waters, CRNP
• Ellen Kligerman Waters, CRNP
• Melinda Waters, CRNP
• Michael Waters

• Skilled Nursing Facility in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.