NPIMap

Organization Active NPI

Hampton Manor of Deerwood LLC

  • Assisted Living Facility
  • Ocala, FL
National Provider Identifier
1972760379
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10647 Issued in FL
Legal business name
HAMPTON MANOR OF DEERWOOD LLC
Practice address
1731 SW 2ND Ave
Suite C
Ocala, FL 34471-8179
Phone
(352) 387-1830
Fax
(352) 873-0237
NPI assigned
May 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Mr. Peder L Johnsen
Title
President
Phone
(352) 387-1830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10647 FL Primary

Addresses

Primary practice location

1731 SW 2ND Ave
Suite C
Ocala, FL 34471-8179

Mailing address

1731 SW 2ND Ave
Suite C
Ocala, FL 34471-8179
Phone (352) 387-1830

Other identifiers 1

IdentifierTypeStateIssuer
14400801MedicaidFL

National Provider Directory

National Provider Directory

Locations

1731 SW 2nd Ave
Ste C
Ocala, FL 34471
Phone (352) 387-1830

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1972760379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 SW 2ND AVE",
            "address_2": "SUITE C",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344718179",
            "telephone_number": "352-387-1830",
            "fax_number": "352-873-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 SW 2ND AVE",
            "address_2": "SUITE C",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344718179",
            "telephone_number": "352-387-1830",
            "fax_number": "352-873-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMPTON MANOR OF DEERWOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSEN",
        "authorized_official_first_name": "PEDER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-387-1830",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14400801",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.