Norwegian Lutheran Bethesda Home Association

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0012229 Issued in IL

Legal business name

NORWEGIAN LUTHERAN BETHESDA HOME ASSOCIATION

Doing business as

Bethesda Home and Retirement Center

Practice address

2833 N Nordica Ave
Chicago, IL 60634-4726

Phone

(773) 622-6144

Fax

(773) 622-8261

NPI assigned

Oct 4, 2005

Last updated

Feb 8, 2012By 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

Mrs. Julie Boggess, NHA

Title

Ceo

Phone

(773) 622-6144

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bethesda Home and Retirement Center Doing business as

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1750378923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2833 N NORDICA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344726",
            "telephone_number": "773-622-6144",
            "fax_number": "773-622-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2833 N NORDICA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344726",
            "telephone_number": "773-622-6144",
            "fax_number": "773-622-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORWEGIAN LUTHERAN BETHESDA HOME ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "BOGGESS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-622-6144",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0012229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "01146",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "5034709",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethesda Home and Retirement Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy A. Norton, PH.D.
• Tiffany S Norton, OT
• Connor V Nortrom
• Allyson Nortz, DPT
• Norwegian American Hosp Community Pharmacy
• Norweigan American Hospital
• Norwestern Memorial Hospital
• Norwood Crossing Association (Norwood Crossing)
• Norwood Health LTD
• Norwood Medical LTD

• Skilled Nursing Facility in Chicago, IL
• Providers in Chicago, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.