NPIMap

Organization Active NPI

North Park Nursing Home

  • Adult Day Care Clinic/Center
  • Rochester, NY
National Provider Identifier
1699824847
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
NORTH PARK NURSING HOME
Practice address
700 Island Cottage Rd
Rochester, NY 14612-2312
Phone
(585) 368-6130
Fax
(585) 368-6030
NPI assigned
Jan 9, 2007
Organization subpart
Yes
Parent organization
NORTH PARK NURSING HOMEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Amanda Teugeman
Title
Administrator, Nha
Phone
(585) 368-6105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

700 Island Cottage Rd
Rochester, NY 14612-2312

Mailing address

700 Island Cottage Rd
Rochester, NY 14612-2312
Phone (585) 368-6130

Other identifiers 1

IdentifierTypeStateIssuer
01535840MedicaidNY

Other names 2

  • Edna Tina Wilson Living Center (ADHC) Doing business as
  • North Park NH ADHC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Park Nursing Home4 organizations share this tax ID, including this one
Part of
North Park Nursing Home

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

700 Island Cottage Rd
Rochester, NY 14612
Phone (585) 368-6100

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1699824847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ISLAND COTTAGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146122312",
            "telephone_number": "585-368-6130",
            "fax_number": "585-368-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 ISLAND COTTAGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146122312",
            "telephone_number": "585-368-6130",
            "fax_number": "585-368-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PARK NURSING HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH PARK NURSING HOME",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "TEUGEMAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "ADMINISTRATOR, NHA",
        "authorized_official_telephone_number": "585-368-6105"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01535840",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edna Tina Wilson Living Center (ADHC)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Park NH ADHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.