Shenandoah Manor, Inc

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

80 Issued in WV

Legal business name

SHENANDOAH MANOR, INC

Doing business as

The Brier

Practice address

601 Rocky Hill Rd
Ronceverte, WV 24970-9757

Phone

(304) 645-7270

NPI assigned

Oct 5, 2005

Last updated

Jun 19, 2008By 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

Linda Turner

Title

Nursing Home Administrator

Phone

(304) 645-7270

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Brier Doing business as

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1093702979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ROCKY HILL RD",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249709757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ROCKY HILL RD",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249709757",
            "telephone_number": "304-645-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH MANOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "NURSING HOME ADMINISTRATOR",
        "authorized_official_telephone_number": "304-645-7270"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "WV",
            "license": "80",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004165000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Brier",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Skilled Nursing Facility in Ronceverte, WV
• Providers in Ronceverte, WV by specialty
• Pediatric Skilled Nursing Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.