Emeritus Corporation

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

310 Issued in VT

Legal business name

EMERITUS CORPORATION

Doing business as

Brookdale Fillmore Pond

Practice address

300 Village LN
Bennington, VT 05201-9041

Phone

(802) 447-7000

NPI assigned

Oct 6, 2011

Last updated

Jul 21, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

BROOKDALE SENIOR LIVING INCAs reported in NPPES

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

Authorized official

Name

Joanne K Leskowicz

Title

Senior Vice President

Phone

(414) 918-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brookdale Fillmore Pond Doing business as

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

CLIA laboratory certificates

Tax ID family

Emeritus Properties-NGH LLC236 organizations share this tax ID, including this one

Part of

Brookdale Senior Living Inc

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1861776080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 VILLAGE LN",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052019041",
            "telephone_number": "802-447-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITUS CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2011-10-06",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "LESKOWICZ",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "VT",
            "license": "310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W322",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Fillmore Pond",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookdale Fillmore Pond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy D'Lynn Eggsware, MC, LPC, LCMHC
• Thomas Mitchell Eggsware II, MA
• Karen Ejeriefe, LICSW
• Lixia Zhao Ellis, M.D., PH.D.
• William Elwell
• Emil P. Miskovsky MD PC (Evergreen)
• Zekariah England
• Mark Epler, PT,DPT,CSCS
• Essential Wellness PLC
• Frank Famiano, MD

• Assisted Living Facility in Bennington, VT
• Providers in Bennington, VT by specialty
• Assisted Living Facility in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.