Five Star Knightsbridge, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FIVE STAR KNIGHTSBRIDGE, LLC

Practice address

4590 Knightsbridge Blvd
Columbus, OH 43214-4326

Phone

(614) 451-6793

Fax

(614) 273-2450

NPI assigned

Dec 6, 2006

Organization subpart

Yes

Parent organization

FIVE STAR KNIGHTSBRIDGE, LLCAs reported in NPPES

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

Authorized official

Name

Katherine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 2

Addresses

Other names 1

• Healthcare Center at the Forum Doing business as

Part of

Five Star Knightsbridge LLC

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1700945920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 KNIGHTSBRIDGE BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144326",
            "telephone_number": "614-451-6793",
            "fax_number": "614-273-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 KNIGHTSBRIDGE BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144326",
            "telephone_number": "614-451-6793",
            "fax_number": "614-273-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR KNIGHTSBRIDGE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR KNIGHTSBRIDGE, LLC",
        "enumeration_date": "2006-12-06",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthcare Center at the Forum",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthcare Center at the Forum",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Columbus, OH
• Providers in Columbus, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.