RPM Indianapolis, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

140133281 Issued in IN

Legal business name

RPM INDIANAPOLIS, LLC

Practice address

7960 N Shadeland Ave
Indianapolis, IN 46250-2041

Phone

(815) 573-5105

NPI assigned

Sep 18, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Blair Moss Minton, RN

Title

President

Phone

(815) 573-5105

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crown Senior Living Doing business as

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1780086082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502041",
            "telephone_number": "815-573-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502041",
            "telephone_number": "815-573-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RPM INDIANAPOLIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "MINTON",
        "authorized_official_first_name": "BLAIR",
        "authorized_official_middle_name": "MOSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-573-5105",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IN",
            "license": "140133281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140133281",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crown Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valisa Jean Roysdon, AUD
• Diane Erna Royston, OTRL
• Donald Arthur Royston, LICENSED PHARMACIST
• Mark Rozales
• David Roznovjak, MD
• Rraine LLC
• RT Home Care LLC
• RTB Prestige Global LLC
• RTC Resource Acquisition Corporation
• RTC Resource Acquisition Corporation

• Assisted Living Facility in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.