EMERITUS CORPORATION , NPI 1205140555 — BROOKDALE KEARNEY NORTHRIDGE in KEARNEY (NE)

NPI 1205140555

9+ Years Experience Organization

EMERITUS CORPORATION

Other organization name: BROOKDALE KEARNEY NORTHRIDGE. Name type code: 3 - doing business as (d/b/ a) name.

07/28/2010
PROVIDER ENUMERATION DATE
05/16/2016
LAST UPDATE DATE
1205140555
NPI NUMBER

About EMERITUS CORPORATION

EMERITUS CORPORATION is a provider established in KEARNEY, NE. The NPI number of EMERITUS CORPORATION is 1205140555 and was assigned on 07/28/2010. The practitioners primary taxonomy code is: 310400000X NE .

Mailing address

  • City: MILWAUKEE
  • State: WI
  • Postal code: 532145647
  • Address: 6737 W WASHINGTON ST
  • Address 2: SUITE 2300

Primary Practice Address

  • Region : KEARNEY, NE
  • NPI : 1205140555
  • Phone : 3086985410
  • Fax : 3086985157
  • Postalcode : 688458305
  • Address : 5410 17TH AVE

Additional identifiers

  • Identifier: 100258917-00
  • Code / Type : 5 - MEDICAID
  • Identifier state : NE

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Assisted Living Facility

  • Taxonomy code: 310400000X
  • License state: NE

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Contacts:

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  • EMERITUS CORPORATION
  • Address : 5410 17TH AVE
  • Region : KEARNEY, NE
  • NPI : 1205140555
  • Phone : 3086985410
  • Fax : 3086985157
  • Postalcode : 688458305

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 6155648131
  • Title or position : EVP, CHIEF ADMIN. OFFICER

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address5410 17TH AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameKEARNEY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNE
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code688458305
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3086985410
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3086985157
The fax number associated with the location address of the provider being identified.
NPI1205140555
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1310400000X
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Provider Enumeration Date07/28/2010
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated05/16/2016
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)EMERITUS CORPORATION
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameBROOKDALE KEARNEY NORTHRIDGE
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address6737 W WASHINGTON ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 2300
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameMILWAUKEE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameWI
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code532145647
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Authorized Official Last NameRICHARDSON
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameBRYAN
The first name of the authorized official
Authorized Official Title or PositionEVP, CHIEF ADMIN. OFFICER
The title or position of the authorized official
Authorized Official Telephone Number6155648131
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1310400000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Provider License Number State Code 1NE
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1100258917-00
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1NE
Other Provider Identifier State #1
X

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