A BANYAN RESIDENCE AT WILDWOOD, LLC
NPI 1083201891
Assisted Living Facility in Oxford, FL

Q: What is A Banyan Residence At Wildwood, LLC's NPI number?

The NPI number for A Banyan Residence At Wildwood, LLC is 1083201891. It was assigned to this organization in the NPPES registry on December 28, 2020.

Q: What is A Banyan Residence At Wildwood, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since December 28, 2020

12427 COUNTY ROAD 101, OXFORD, FL 34484(954) 854-8895(941) 412-4749 Get Directions Write a Review

NPPES record last updated: December 28, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About A Banyan Residence At Wildwood, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

A BANYAN RESIDENCE AT WILDWOOD, LLC (NPI 1083201891) is a healthcare organization registered as an assisted living facility in Oxford, Florida and active in the NPI registry since December 2020. The organization lists Greg Anderson, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1083201891

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameA BANYAN RESIDENCE AT WILDWOOD, LLC

Location Address12427 COUNTY ROAD 101Oxford, FL 34484-2941

Mailing Address2515 Sherman Oak DrNorth Port, FL 34289-2390 · (941) 249-0456 · Fax (941) 412-4749

Phone(954) 854-8895

Fax(941) 412-4749

Organization SubpartYesParent: A Banyan Residence Assisted Living Llc

Authorized OfficialGreg AndersonManaging Member · (954) 536-4066

Enumeration DateDecember 28, 2020

NPPES CertifiedDecember 28, 2020

✔ NPI 1083201891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

12427 COUNTY ROAD 101, Oxford, FL 34484

Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is A Banyan Residence At Wildwood, LLC's NPI number?

The NPI number for A Banyan Residence At Wildwood, LLC is 1083201891. It was assigned to this organization in the NPPES registry on December 28, 2020.

Where is A Banyan Residence At Wildwood, LLC located?

A Banyan Residence At Wildwood, LLC is located at 12427 County Road 101, Oxford, FL 34484. The listed phone number is (954) 854-8895.

What is A Banyan Residence At Wildwood, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for A Banyan Residence At Wildwood, LLC was last updated on December 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.