Eastgate Manor

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

46002337A Issued in IN

Legal business name

EASTGATE MANOR

Practice address

2119 E National Hwy
Washington, IN 47501-4507

Phone

(812) 254-3301

Fax

(812) 257-0039

NPI assigned

Aug 2, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Sabrina Marie Johnson, PTA

Title

Facility Rehab Coordinator

Phone

(812) 254-3301

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1003162512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 E NATIONAL HWY",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475014507",
            "telephone_number": "812-254-3301",
            "fax_number": "812-257-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 E NATIONAL HWY",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475014507",
            "telephone_number": "812-254-3301",
            "fax_number": "812-257-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTGATE MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "FACILITY REHAB COORDINATOR",
        "authorized_official_telephone_number": "812-254-3301",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "46002337A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Michael S. Walker D.D.S., P.C.
• Jeremy D Ducharme
• Barbara Sue Duncan
• Miranda M Dunn, MSW
• Valerie A Dyer, NP
• Kaylee Rose Edwards
• Montana Elizabeth Edwards
• Larcy Joy Emmert, SLP
• Ashley Epperson
• Extendicare Homes, Inc.

• Skilled Nursing Facility in Washington, IN
• Providers in Washington, IN by specialty
• Skilled Nursing Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.