Diversicare of Avon, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DIVERSICARE OF AVON, LLC

Practice address

32900 Detroit Rd
Avon, OH 44011-2018

Phone

(440) 937-6201

Fax

(440) 937-5955

NPI assigned

Jul 12, 2014

Organization subpart

Yes

Parent organization

DIVERSICARE LEASING COMPANY II, LLCAs reported in NPPES

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

Authorized official

Name

Kelly J Gill

Title

President and Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other names 1

• Avon Place Doing business as

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

{
    "created_epoch": "1405123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405123200000",
    "number": "1891102760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32900 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440112018",
            "telephone_number": "440-937-6201",
            "fax_number": "440-937-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32900 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440112018",
            "telephone_number": "440-937-6201",
            "fax_number": "440-937-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF AVON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE LEASING COMPANY II, LLC",
        "enumeration_date": "2014-07-12",
        "last_updated": "2014-07-12",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avon Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah P Diamond, CNP
• Noah Jake Diaz de la Cuesta
• Chrindye Renee Dietz, PT
• Tina M Dinardo, PT
• Discount Drug Mart Inc
• Addison Rae Dixon
• Joanne Doran, M.ED., ED.S
• Abelardo Dorantes, P.T.
• Cynthia Ann Dougher, P.T., A.T.P.
• Angela Dover, PHD, LPCC-S

• Skilled Nursing Facility in Avon, OH
• Providers in Avon, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2014; 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.