NPIMap

Organization Active NPI

Emeritus Corporation

Doing business as Brookdale Skylyn

  • Assisted Living Facility
  • Spartanburg, SC
National Provider Identifier
1679780662
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
0856 Issued in SC
Legal business name
EMERITUS CORPORATION
Doing business as
Brookdale Skylyn
Practice address
1705 Skylyn Drive
Spartanburg, SC 29307
Phone
(864) 582-6838
Fax
(864) 852-1270
NPI assigned
May 17, 2007
Last updated
Jun 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Authorized official

Name
Bryan Richardson
Title
Evp, Chief Admin. Officer
Phone
(615) 564-8131

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X CRC856 SC
Assisted Living Facility 310400000X CRC-0856 SC
Assisted Living Facility 310400000X 0856 SC Primary

Addresses

Primary practice location

1705 Skylyn Drive
Spartanburg, SC 29307

Mailing address

6737 W Washington St Ste 2300
Milwaukee, WI 53214-5650
Phone (414) 918-5000

Other identifiers 1

IdentifierTypeStateIssuer
RC0856MedicaidSC

Other names 1

  • Brookdale Skylyn Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Emeritus Properties Ark Willow Brook LLC236 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1679780662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST STE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145650",
            "telephone_number": "414-918-5000",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 SKYLYN DRIVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29307",
            "telephone_number": "864-582-6838",
            "fax_number": "864-852-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITUS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EVP, CHIEF ADMIN. OFFICER",
        "authorized_official_telephone_number": "615-564-8131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "CRC856",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "CRC-0856",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SC",
            "license": "0856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RC0856",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Skylyn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.