Larue County Geriatric Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100277 Issued in KY

Legal business name

LARUE COUNTY GERIATRIC CENTER, INC.

Doing business as

Sunrise Manor

Practice address

80 Phillips LN
Hodgenville, KY 42748-1645

Phone

(270) 358-3103

Fax

(270) 358-8412

NPI assigned

Jun 1, 2005

Last updated

May 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Daphne S. Loyall

Title

Administrator

Phone

(270) 358-3103

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Sunrise Manor Doing business as

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1003818303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 PHILLIPS LN",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "427481645",
            "telephone_number": "270-358-3103",
            "fax_number": "270-358-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PHILLIPS LN",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "427481645",
            "telephone_number": "270-358-3103",
            "fax_number": "270-358-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARUE COUNTY GERIATRIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "LOYALL",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "270-358-3103",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "KY",
            "license": "750086",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100277",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "KY",
            "license": "100277",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12502233",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100277",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43010628",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Inside Out, LLC
• Brittain Cole Jackson, PHARMD
• Shauna Kristen Johnson, APRN
• Larue County Board of Education
• Larue County County Treasurer (Larue County EMS)
• Mariah Lavere
• Lincoln Trail District Health Department (LaRue County Health Center)
• Lincoln Way LLC Janice Diane Haycraft Single MBR
• Louisville Optometric Centers, III PSC (VisionFirst)
• Louisville Optometric Centers, III PSC (VisionFirst)

• Skilled Nursing Facility in Hodgenville, KY
• Providers in Hodgenville, KY by specialty
• Skilled Nursing Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.