NPIMap

Organization Active NPI

Omni Manor, Inc.

  • Assisted Living Facility
  • Warren, OH
National Provider Identifier
1831648450
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
OMNI MANOR, INC.
Practice address
2 Windsor PL
Warren, OH 44483-1456
Phone
(330) 545-1550
NPI assigned
Sep 23, 2016
Last updated
Sep 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Authorized official

Name
Mr. John J Masternick
Title
Owner/President
Phone
(330) 545-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

2 Windsor PL
Warren, OH 44483-1456

Mailing address

2 Windsor PL
Warren, OH 44483-1456

Other names 1

  • Armstrong Memory Care Assisted Living Residence Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2284063Armstrong Memory Care2 Windsor Place, Warren, OH 44483Certificate of waiverJun 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Omni Manor Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

2 Windsor Pl
Warren, OH 44483
Phone (330) 545-1550

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1831648450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WINDSOR PL",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WINDSOR PL",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831456",
            "telephone_number": "330-545-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "MASTERNICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "330-545-1550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Armstrong Memory Care Assisted Living Residence",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.