NPIMap

Organization Active NPI

LP Prestonsburg LLC

  • Skilled Nursing Facility
  • Prestonsburg, KY
National Provider Identifier
1033300314
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
100126 Issued in KY
Legal business name
LP PRESTONSBURG LLC
Doing business as
Prestonsburg Health Care Center
Practice address
147 N Highland Ave
Prestonsburg, KY 41653-7748
Phone
(606) 886-2378
Fax
(606) 889-9438
NPI assigned
Aug 5, 2007
Organization subpart
Yes
Parent organization
LP O HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
Mr. John Harrison
Title
Cfo
Phone
(502) 568-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 100126 KY Primary

Addresses

Primary practice location

147 N Highland Ave
Prestonsburg, KY 41653-7748

Mailing address

12201 Bluegrass Parkway
Louisville, KY 40299-2361
Phone (502) 568-7800

Other names 1

  • Prestonsburg Health Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070921000060 DE Part A Provider - Skilled Nursing Facility 4486748464 Practice locations: Prestonsburg, KY

Skilled nursing facility certification: CCN 185304

Legal name
LP PRESTONSBURG LLC
Doing business as
PRESTONSBURG HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1992
Last certification
Aug 26, 2022
Beds
56
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Signature Healthcare
Organization structure
LLCProprietary
Incorporated
Nov 8, 2006 in DE
Enrollment address
147 N Highland Ave
Prestonsburg, KY 41653-7748
Nursing home name
PRESTONSBURG HEALTH CARE CENTER
Affiliated entity
SIGNATURE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Prestonsburg Health Care CenterCCN 185304 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5649.7 residents per day on average
Chain
Signature Healthcare67 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0677207LP Prestonsburg, LLC Dba147 North Highland Avenue, Prestonsburg, KY 41653Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lynn D Watts Individual W-2 Managing EmployeeAdministrator Sep 2, 1986
Operational/Managerial ControlAdministrator Sep 2, 1986
LP O Holdings LLC Organization, Louisville, KY Corporation 5% Or Greater Direct Ownership Interest Nov 1, 2007 100%
Ira Smedra Individual 5% Or Greater Indirect Ownership InterestBoard Member Nov 1, 2007 12%
Agemo Holdings LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 100%
Lpsnf II LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 74%
Signature Healthcare LLC Organization, Louisville, KY LLC Other Nov 1, 2007
John H Harrison Individual Corporate OfficerCfo Nov 1, 2007
Wheaten LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 5%
Elmer Joseph Steier III Individual 5% Or Greater Indirect Ownership InterestPresident and Ceo Nov 1, 2007 20%
Jjla LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 20%

Facilities with the same owner 64

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 64

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1033300314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PARKWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800",
            "fax_number": "502-568-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 N HIGHLAND AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416537748",
            "telephone_number": "606-886-2378",
            "fax_number": "606-889-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP PRESTONSBURG LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LP O HOLDINGS LLC",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-568-7800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestonsburg Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prestonsburg Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prestonsburg, KY

Sources for this page

Verify at the official NPI Registry.