Bayshore Duluth Management, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BAYSHORE DULUTH MANAGEMENT, LLC

Practice address

1601 Saint Louis Ave
Duluth, MN 55802-2442

Phone

(218) 727-8651

NPI assigned

May 8, 2013

Organization subpart

No

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

Authorized official

Name

Eliezer Deitsch

Title

Manager

Phone

(516) 250-1260

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1821433426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 PARSONS BLVD STE 1001",
            "address_2": "C/O PARAGON HEALTHCARE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113654131",
            "telephone_number": "718-408-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SAINT LOUIS AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022442",
            "telephone_number": "218-727-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSHORE DULUTH MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-08",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "DEITSCH",
        "authorized_official_first_name": "ELIEZER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-250-1260"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Alvin Baxley, P.A.
• John Kenneth Baxter, MD
• Michael Jon Bayer
• Shannon C Bayless, MSW, LICSW
• Bayshore Duluth Management, LLC
• Rebekah Beach, MD
• Beacon of Strength Mental Health Services, LLC
• Beacon of Strength Supportive Services
• Beacon of Strength Supportive Services, LLC
• Nicholas Beattie, PHARMD

• Skilled Nursing Facility in Duluth, MN
• Providers in Duluth, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.