Waverly Assisted Living, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

WAVERLY ASSISTED LIVING, LLC

Doing business as

Wellness at Home in Albany

Practice address

2853 Salem Ave SE Ste a
Albany, OR 97321

Phone

(541) 650-6200

Fax

(541) 981-2211

NPI assigned

Nov 28, 2018

Last updated

Aug 9, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kim Bistrong, PT

Title

Administrator

Phone

(971) 280-0677

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wellness at Home in Albany Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles T McGlade, MD

  • Vascular & Interventional Radiology Physician
  • Springfield, OR
  • NPI 1235154212
  NPD

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1730659228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2853 SALEM AVE SE STE A",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "97321",
            "telephone_number": "541-650-6200",
            "fax_number": "541-981-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2853 SALEM AVE SE STE A",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "97321",
            "telephone_number": "541-650-6200",
            "fax_number": "541-981-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "BISTRONG",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "971-280-0677",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY LICENSE",
            "identifier": "38-7165",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500757550",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness at Home in Albany",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellness at Home in Albany",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Ward
• Whitney Warren
• Anna Wascher, LPC
• Madison Mae Watson, CCC-SLP
• Waverly Assisted Living, LLC (Wellness at Home in Albany)
• Waverly Dental LLC
• Matthew Weaver
• Patty Weeks, RNFA
• Sara Weeks
• Kaylin Kimberly Weerts

• In Home Supportive Care Agency in Albany, OR
• Providers in Albany, OR by specialty
• In Home Supportive Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.