Kingston Residence of Vermilion, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2239R Issued in OH

Legal business name

KINGSTON RESIDENCE OF VERMILION, LLC

Practice address

6010 W Lake Rd
Vermilion, OH 44089-2838

Phone

(440) 967-2424

Fax

(440) 967-2669

NPI assigned

Aug 5, 2011

Last updated

Aug 5, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

KINGSTON HEALTHCARE, INCAs reported in NPPES

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

Authorized official

Name

Mr. Larry Nirschl

Title

Treasurer

Phone

(419) 247-2824

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Huron Podiatry LLC

  • Podiatrist
  • Huron, OH
  • NPI 1487675211

  O20041129000326

  Same enrollment

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Martin Nicholas Lesnak, D.P.M.

  • Podiatrist
  • Huron, OH
  • NPI 1659359529
  NPD
• Angela Lynn Fraifogl, DPM

  • Podiatrist
  • Huron, OH
  • NPI 1356364913
  NPD (past)

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1851670020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE",
            "address_2": "SUITE #1960",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "419-247-2880",
            "fax_number": "419-247-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 W LAKE RD",
            "city": "VERMILION",
            "state": "OH",
            "postal_code": "440892838",
            "telephone_number": "440-967-2424",
            "fax_number": "440-967-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSTON RESIDENCE OF VERMILION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KINGSTON HEALTHCARE, INC",
        "enumeration_date": "2011-08-05",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "NIRSCHL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "419-247-2824",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2239R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Lynn Jones, RN (REGISTERED NURSE
• David R. Kasmier-Milburn
• Richard John Kearns, DC
• Tisha Marie Kelly, STNA
• Kingston of Vermilion, LLC (Kingston of Vermilion)
• KJJ Healthcare LLP
• Denise Klein
• Olga Kontarovich
• Robriana Kotnik
• Faith Elizabeth Krick

• Assisted Living Facility in Vermilion, OH
• Providers in Vermilion, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.