Shady Oaks Living Center

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL 8450 Issued in FL

Legal business name

SHADY OAKS LIVING CENTER

Practice address

2208 E 138TH Ave
Tampa, FL 33613-4435

Phone

(813) 978-0819

Fax

(813) 425-6925

NPI assigned

Nov 4, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Wilfred Joseph

Title

President/Administrator

Phone

(813) 978-0819

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1699076703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280339",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336820339",
            "telephone_number": "813-978-0819",
            "fax_number": "813-425-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 E 138TH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134435",
            "telephone_number": "813-978-0819",
            "fax_number": "813-425-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY OAKS LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "WILFRED",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "813-978-0819",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL 8450",
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL 8450",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140792900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SH Northdale, LLC
• Elena Shackelford, OT
• Margaret Shackelford
• Nathan Shadd
• Megan Elizabeth Shader, PHARM.D.
• Shady Palms Retirement Homes, Inc.
• Kristy Marie Shaeer, PHARMD
• Claudia Shafer
• Andrea Theresia Shaffer, ARNP
• Claudia Shaffer, M.S., CCC-SLP

• Assisted Living Facility in Tampa, FL
• Providers in Tampa, 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 Nov 4, 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.