OrganizationActive
A Banyan Residence at Wildwood, LLC
NPI 1083201891 · Assisted Living Facility · Oxford, FL
Provider details
- NPI number
- 1083201891
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Parent organization
- A Banyan Residence Assisted Living LLC
- Organization subpart
- Yes
- Authorized official
- Greg Anderson, Managing Member(954) 536-4066
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12427 County Road 101
Oxford, FL 34484-2941
Phone: (954) 854-8895
Fax: (941) 412-4749
Approximate (ZIP-level) locationGet directions
Mailing address
2515 Sherman Oak Dr
North Port, FL 34289-2390
Registry dates
- Enumerated
- 2020-12-28
- Last updated
- 2020-12-28
- Certified
- 2020-12-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.