Churchill Manor

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CHURCHILL MANOR

Practice address

700 E Brighton Ave
Syracuse, NY 13205-2201

Phone

(315) 492-1329

NPI assigned

Jul 11, 2007

Organization subpart

No

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

Authorized official

Name

Maria Johnson

Title

Billing Supervisor

Phone

(315) 413-3688

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1851590830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E BRIGHTON AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052201",
            "telephone_number": "315-492-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E BRIGHTON AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052201",
            "telephone_number": "315-492-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCHILL MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "315-413-3688"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01445252",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Miaoling Chu, MD
• Chung-Taik Chung, M.D.
• Stephanie Chung, DO
• Yelim Chung, MD
• Alexandra Renee Church, LMSW
• Kelly Churney, LPN
• A. James Ciaccio, MD, FACEP
• Stephen Ciaccio
• Kathleen M. Ciarpelli, R.N.
• Phillip Martin Cicco, N.P.

• Assisted Living Facility in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Assisted Living Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.