Shady Oaks Rest Home Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

10293 Issued in FL

Legal business name

SHADY OAKS REST HOME INC.

Practice address

1208 Kennedy Rd
Daytona Beach, FL 32117

Phone

(386) 253-6993

NPI assigned

May 31, 2012

Organization subpart

No

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

Authorized official

Name

Mr. James Ham

Title

Manager

Phone

(386) 562-0870

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1699036285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 KENNEDY RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-253-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 KENNEDY RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-253-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY OAKS REST HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "386-562-0870",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10293",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "10293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sergio M Zamora MD PLC
• Samantha Serle
• Robert A Session Jr.
• Dahlia Shaaban
• April Marie Shadeed, ARNP, FNP-C
• Cheryl Lynette Shady
• Jessica Shaffer, MA
• Aesha Shah, DO
• Aeshna T Shah, MD
• Snehal Shah, MD

• Assisted Living Facility in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.