Dublin Convalarium Operating Company, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DUBLIN CONVALARIUM OPERATING COMPANY, LLC

Doing business as

Convalarium at Indian Run

Practice address

6430 Post Rd
Dublin, OH 43016-1226

Phone

(614) 761-1188

NPI assigned

Jan 20, 2021

Last updated

Dec 17, 2024By 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

Mr. Jeffrey Degyansky, LNHA

Title

Vice President of Operations

Phone

(330) 620-7828

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Convalarium at Indian Run 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

Convalarium at Indian Run2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dublin Convalarium Operating Company, LLC

  dba The Convalarium

  • Skilled Nursing Facility
  • Dublin, OH
  • NPI 1992321392
  NPD tax ID

Locations

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1942890306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 POST RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430161226",
            "telephone_number": "614-761-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 POST RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430161226",
            "telephone_number": "614-761-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBLIN CONVALARIUM OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-20",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "DEGYANSKY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "330-620-7828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "1900R",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Convalarium at Indian Run",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Convalarium at Indian Run",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cierra Dryden
• Alaina Drysdale
• Evmy Valentina Duarte, RBT
• Dublin Chiropractic Center, Inc.
• Dublin City Schools
• Dublin Convalarium Operating Company, LLC (The Convalarium)
• Dublin Counseling Group, LLC
• Dublin Diagnostic Imaging LLC
• Dublin Direct Care LLC (Dublin Direct Care)
• Dublin Endodontics LLC

• Assisted Living Facility in Dublin, OH
• Providers in Dublin, 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 Dec 17, 2024; 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.