NPIMap

Organization Active NPI

Five Star Quality Care - VA, LLC

Doing business as Dominion Village at Poquoson

  • Assisted Living Facility
  • Poquoson, VA
National Provider Identifier
1801839089
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
PLO-04-159 Issued in VA
Legal business name
FIVE STAR QUALITY CARE - VA, LLC
Doing business as
Dominion Village at Poquoson
Practice address
531 Wythe Creek Rd
Poquoson, VA 23662-1562
Phone
(757) 868-0335
Fax
(757) 874-6919
NPI assigned
Jun 14, 2006
Last updated
Jun 27, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
FIVE STAR QUALITY CARE - VA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Authorized official

Name
Bruce J Mackey Jr.
Title
President & Chief Executive Officer
Phone
(617) 796-8214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X PLO-04-159 VA Primary

Addresses

Primary practice location

531 Wythe Creek Rd
Poquoson, VA 23662-1562

Mailing address

400 Centre St
Newton, MA 02458-2094
Phone (617) 796-8387

Other names 1

  • Dominion Village at Poquoson Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Five Star Quality Care - VA LLC4 organizations share this tax ID, including this one
Part of
Five Star Quality Care - VA LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1801839089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582094",
            "telephone_number": "617-796-8387",
            "fax_number": "617-796-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 WYTHE CREEK RD",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621562",
            "telephone_number": "757-868-0335",
            "fax_number": "757-874-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR QUALITY CARE - VA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR QUALITY CARE - VA, LLC",
        "enumeration_date": "2006-06-14",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "MACKEY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8214",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "VA",
            "license": "PLO-04-159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dominion Village at Poquoson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poquoson, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.