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A Banyan Residence at Wildwood, LLC

NPI 1083201891ActiveOrganization· Assisted Living Facility· Oxford, FL

Assisted Living Facility in Oxford, Florida, registered in NPPES in December 2020, part of A Banyan Residence Assisted Living LLC. The authorized official on file is Greg Anderson, Managing Member.

Overview

NPI1083201891
StatusActive
Entity typeOrganization (subpart)
Parent organizationA Banyan Residence Assisted Living LLC
NPI issuedDec 28, 2020
Last updated in NPPESDec 28, 2020
Certified by providerDec 28, 2020

Specialties and licenses

TaxonomyCodeLicenseState
Assisted Living Facility Primary310400000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

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