Premier Estates 523, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PREMIER ESTATES 523, LLC

Practice address

6099 Fairfield Rd
Oxford, OH 45056-1507

Phone

(513) 523-6353

NPI assigned

Oct 26, 2017

Organization subpart

No

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

Authorized official

Name

Adrianna Bancroft

Title

Receptionist

Phone

(941) 758-4745

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518480000000",
    "number": "1831601160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085509",
            "telephone_number": "941-758-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6099 FAIRFIELD RD",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450561507",
            "telephone_number": "513-523-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ESTATES 523, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2018-02-13",
        "status": "A",
        "authorized_official_last_name": "BANCROFT",
        "authorized_official_first_name": "ADRIANNA",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "941-758-4745"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0250629",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah J Pettit, MPT
• Elizabeth P Polanka, LPCC IMFT
• Ashlie Porter, ATC, LAT
• Alexis Marie Potestivo
• Power Journey
• Melissa Ann Price, M.S., CCC-SLP
• Kasey Lynn Prince, MSW, LSW
• Pristine Senior Living of Oxford, LLC
• Private Healthcare Facilities
• Melanie D. Rakushin, MSW LISW-S

• Skilled Nursing Facility in Oxford, OH
• Providers in Oxford, 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 Feb 13, 2018; 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.