Organization Active NPI

Ec Opco Medina, LLC

  • Assisted Living Facility
  • Medina, OH
National Provider Identifier
1841799012
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EC OPCO MEDINA, LLC
Practice address
1046 N Jefferson St
Medina, OH 44256-1102
Phone
(330) 721-2000
NPI assigned
Feb 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Authorized official

Name
Amy W. Fleming
Title
Controller
Phone
(971) 337-3922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X OH Primary

Addresses

Primary practice location

1046 N Jefferson St
Medina, OH 44256-1102

Mailing address

5885 Meadows Rd Ste 500
Lake Oswego, OR 97035-8646
Phone (971) 254-1368

Other identifiers 1

IdentifierTypeStateIssuer
1902125198MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1841799012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5885 MEADOWS RD STE 500",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358646",
            "telephone_number": "971-254-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 N JEFFERSON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561102",
            "telephone_number": "330-721-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EC OPCO MEDINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "971-337-3922"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902125198",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.