BCC Medina Operations, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

2227R Issued in OH

Legal business name

BCC MEDINA OPERATIONS, LLC

Doing business as

Elmcroft of Medina

Practice address

1046 N Jefferson St
Medina, OH 44256-1102

Phone

(330) 721-2000

Fax

(330) 723-0742

NPI assigned

Aug 2, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Robin L. Barber, ESQ.

Title

Vice President and Secretary

Phone

(502) 753-6004

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elmcroft of Medina Doing business as

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1730493727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 ORMSBY STATION RD",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234081",
            "telephone_number": "502-753-6004",
            "fax_number": "502-753-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 N JEFFERSON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561102",
            "telephone_number": "330-721-2000",
            "fax_number": "330-723-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BCC MEDINA OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "502-753-6004",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "OH",
            "license": "2227R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENTIAL CARE FACILITY LICENSE",
            "identifier": "2227R",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmcroft of Medina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candyce Lynn Bauer-Rick, LPN
• Kecia Bauer
• Thomas Michael Bauer, R.PH.
• Nicole Baum, LSW
• Karen S Bauman, LISW-S
• BD Camelot Opco, LLC (Brookdale Camelot Medina)
• BD Medina South Opco LLC (Brookdale Medina South)
• BD Medina South Opco, LLC
• Brooke Beans
• Hailey Beard, LMHC

• Adult Care Home Facility in Medina, OH
• Providers in Medina, OH by specialty
• Adult Care Home Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.