Meridian Manor Operatons LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MERIDIAN MANOR OPERATONS LLC

Doing business as

Meridian Manor

Practice address

163 Wayzata Blvd W
Wayzata, MN 55391-1562

Phone

(952) 473-3700

Fax

(952) 404-1540

NPI assigned

Dec 10, 2012

Organization subpart

No

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

Authorized official

Name

Judi L Buxo

Title

Sr VP - Director of Asset Managemen

Phone

(515) 875-4500

Specialties & licenses 1

Addresses

Other names 1

• Meridian Manor Doing business as

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355097600000",
    "number": "1740525229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LOCUST ST STE 820",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503092334",
            "telephone_number": "515-875-4500",
            "fax_number": "515-875-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 WAYZATA BLVD W",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911562",
            "telephone_number": "952-473-3700",
            "fax_number": "952-404-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN MANOR OPERATONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-10",
        "last_updated": "2012-12-10",
        "status": "A",
        "authorized_official_last_name": "BUXO",
        "authorized_official_first_name": "JUDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR VP - DIRECTOR OF ASSET MANAGEMEN",
        "authorized_official_telephone_number": "515-875-4500"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.