Manor Care of Alexandria VA LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2644 Issued in VA

Legal business name

MANOR CARE OF ALEXANDRIA VA LLC

Practice address

1510 Collingwood Rd
Alexandria, VA 22308-1605

Phone

(703) 765-6107

Fax

(703) 765-3131

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Alexandria) Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642896000000",
    "number": "1104861673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 COLLINGWOOD RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223081605",
            "telephone_number": "703-765-6107",
            "fax_number": "703-765-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF ALEXANDRIA VA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104861673",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Alexandria)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paula A Manion, CPNP
• Rajvinder Kaur Mann, M.D.
• Anne Marie Manner, LPC
• Christa Mannino
• Omid Manoochehri
• Wichayapha Manorak, DDS
• Rebecca Raymond Manthey, M.A., L.P.C.
• Kelvin Manurs, PRS
• Jennifer Lux Manz
• Katherine Jane Manzanares

• Skilled Nursing Facility in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; 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.