CHS - Lake Erie, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

6265 Issued in OH

Legal business name

CHS - LAKE ERIE, INC

Doing business as

Carington Park

Practice address

2217 West Ave
Ashtabula, OH 44004-3107

Phone

(440) 964-8446

Fax

(440) 964-9083

NPI assigned

Dec 7, 2005

Last updated

Mar 9, 2011By 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

Brian Colleran

Title

President

Phone

(440) 614-0160

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carington Park Doing business as

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1770568297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 COUNTRY CLUB BLVD",
            "address_2": "SUITE 255",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705344",
            "telephone_number": "440-614-0160",
            "fax_number": "440-614-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 WEST AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440043107",
            "telephone_number": "440-964-8446",
            "fax_number": "440-964-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS - LAKE ERIE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "COLLERAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-614-0160"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "6265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2339268",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carington Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Padmaja Chilukoti, MBBS, DGO
• James Nam Jae Cho, MD
• Suk Kon Choi, MD
• Choong H. Kim, M.D., Inc.
• Joyce Ann Christiansen
• CHS of Ashtabula Inc (Capital Health Home Care)
• Christina Cicon
• Moises Cirilo Escobar
• City of Ashtabula Ohio
• City of Ashtabula Ohio

• Skilled Nursing Facility in Ashtabula, OH
• Providers in Ashtabula, 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 9, 2011; 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.