9035 Bryan Dairy Road Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF130471002 Issued in FL

Legal business name

9035 BRYAN DAIRY ROAD OPERATIONS LLC

Doing business as

Bardmoor Oaks Healthcare and Rehabilitation Center

Practice address

9035 Bryan Dairy Rd
Largo, FL 33777-1104

Phone

(727) 395-9619

Fax

(727) 392-7203

NPI assigned

Dec 27, 2011

Last updated

Nov 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Ussery

Title

VP

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bardmoor Oaks Healthcare and Rehabilitation Center Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1932478583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9035 BRYAN DAIRY RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337771104",
            "telephone_number": "727-395-9619",
            "fax_number": "727-392-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9035 BRYAN DAIRY RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337771104",
            "telephone_number": "727-395-9619",
            "fax_number": "727-392-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "9035 BRYAN DAIRY ROAD OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "USSERY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF130471002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004387600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 Concourse Pkwy S Ste 200",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bardmoor Oaks Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Largo, FL
• Providers in Largo, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.