NPIMap

Organization Active NPI

LP Carrollton, LLC

  • Skilled Nursing Facility
  • Carrollton, KY
National Provider Identifier
1134599525
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LP CARROLLTON, LLC
Practice address
1206 11TH St
Carrollton, KY 41008-9704
Phone
(502) 732-6683
Fax
(502) 732-0330
NPI assigned
Sep 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 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 Primary

Addresses

Primary practice location

1206 11TH St
Carrollton, KY 41008-9704

Mailing address

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

Other names 1

  • Signature Healthcare of Carrollton Rehab & Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160104000321 KY Part A Provider - Skilled Nursing Facility 7517269889 Practice locations: Carrollton, KY

Skilled nursing facility certification: CCN 185205

Legal name
LP CARROLLTON LLC
Doing business as
SIGNATURE HEALTHCARE OF CARROLLTON REHAB & WELLNESS CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 5, 1990
Last certification
Apr 12, 2024
Beds
78
Ownership / control type
Corporation
Multi-facility organization
Signature Healthcare
Organization structure
LLCProprietary
Incorporated
Aug 20, 2015 in DE
Enrollment address
1206 11TH St
Carrollton, KY 41008-9704
Nursing home name
SIGNATURE HEALTHCARE OF CARROLLTON REHAB & WELLNESS CENTER
Affiliated entity
SIGNATURE HEALTHCARE

National Provider Directory

National Provider Directory
Tax ID family
Green Valeey Health Rehabilitation Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Alan Wade Individual W-2 Managing EmployeeAdministrator May 30, 2023
Ira Smedra Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2015 12%
Asbr Holdings LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest May 1, 2018 100%
SHC LP Holdings LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 1, 2015 100%
Lpsnf LLC Organization, Los Angeles, CA LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 1, 2015 74%
John H Harrison Individual Corporate OfficerCfo Nov 1, 2007
Wheaten LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2015 5%
Elmer Joseph Steier III Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2015 20%
Jjla LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 1, 2015 20%

Facilities with the same owner 67

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

View all 67

Practitioners 2

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.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Signature Healthcare of Carrollton Rehab & WellnesCCN 185205
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 5, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7864.3 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
18D0669207Signature Healthcare of Carrollton Rehab1206 11TH Street, Carrollton, KY 41008Certificate of waiverAug 31, 2026

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1134599525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800",
            "fax_number": "502-804-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 11TH ST",
            "city": "CARROLLTON",
            "state": "KY",
            "postal_code": "410089704",
            "telephone_number": "502-732-6683",
            "fax_number": "502-732-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP CARROLLTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-29",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Healthcare of Carrollton Rehab & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Signature Healthcare of Carrollton Rehab & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, KY

Sources for this page

Verify at the official NPI Registry.