Organization Active NPI

Harborview Dover, LLC

  • Skilled Nursing Facility
  • Georgetown, KY
National Provider Identifier
1053953406
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HARBORVIEW DOVER, LLC
Practice address
112 Dover Dr
Georgetown, KY 40324-9741
Phone
(502) 863-9529
Fax
(502) 863-2862
NPI assigned
Oct 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Authorized official

Name
David Englander
Title
Member
Phone
(516) 523-4822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

112 Dover Dr
Georgetown, KY 40324-9741

Mailing address

112 Dover Dr
Georgetown, KY 40324-9741
Phone (502) 863-9529

Other identifiers 1

IdentifierTypeStateIssuer
100480OtherKYLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL harborviewcorp.com

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
18D0962596Harborview Dover, LLC112 Dover Drive, Georgetown, KY 40324Certificate of waiverJul 7, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1053953406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 DOVER DR",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249741",
            "telephone_number": "502-863-9529",
            "fax_number": "502-863-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 DOVER DR",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249741",
            "telephone_number": "502-863-9529",
            "fax_number": "502-863-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORVIEW DOVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "ENGLANDER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "516-523-4822"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "100480",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "harborviewcorp.com",
            "affiliation": "N",
            "address_1": "112 Dover Dr",
            "city": "Georgetown",
            "state": "KY",
            "country_code": "US",
            "postal_code": "403249741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.