Presbyterian Homes and Services of Kentucky, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100242 Issued in KY

Legal business name

PRESBYTERIAN HOMES AND SERVICES OF KENTUCKY, INC

Practice address

2116 Buechel Bank Rd
Louisville, KY 40218-3521

Phone

(502) 259-9101

Fax

(502) 259-9109

NPI assigned

Sep 29, 2005

Organization subpart

No

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

Authorized official

Name

Hattie Wagner

Title

Ceo/President

Phone

(502) 259-9101

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 3

• Lumina of Westminster Terrace Doing business as
• Presbyterian Homes of Louisville Doing business as
• Westminster Terrace Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 186652

Legal name

LUMINA OF WESTMINSTER TERRACE

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Apr 24, 2009

Last certification

Sep 11, 2015

Ownership / control type

VOLUNTARY NON PROFIT CHURCH

Facility address

2116 Buechel Bank Road
Buechel, KY 40218

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

CLIA laboratory certificates

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1124015805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18067",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402610067",
            "telephone_number": "502-259-9101",
            "fax_number": "502-259-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 BUECHEL BANK RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402183521",
            "telephone_number": "502-259-9101",
            "fax_number": "502-259-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOMES AND SERVICES OF KENTUCKY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "HATTIE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "502-259-9101"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "KY",
            "license": "101046",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12501904",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SKILLED NURSING FACILITY LICENSE",
            "identifier": "100242",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT REHABILITATION LICENSE",
            "identifier": "101046",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lumina of Westminster Terrace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presbyterian Homes of Louisville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Westminster Terrace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Westminster Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premise Health of West Virginia Medical, Medical Corporation
• Premise Health of West Virginia Medical, Medical Corporation
• Prencare of Kentucky, Inc
• Shavon Prentice, APRN
• Travis Jason Prentice
• Presbyterian Homes and Services of Kentucky, Inc
• Prescient Medicine Holdings, Inc.
• Prescott Plastic Surgery & Med Spa PLLC
• Angela Te-Fang Prescott, M.D.
• Rachel Grey Prescott, CRNA

• Skilled Nursing Facility in Louisville, KY
• Providers in Louisville, 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 Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.