Hanging Rock LTC, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100767 Issued in KY

Legal business name

HANGING ROCK LTC, LLC

Doing business as

Tri-Cities Nursing and Rehabilitation Center

Practice address

19101 N US Highway 119
Cumberland, KY 40823-8107

Phone

(606) 589-5421

Fax

(606) 589-2097

NPI assigned

Jun 25, 2006

Last updated

Jul 16, 2021By 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

Gale Boice

Title

Cfo

Phone

(252) 523-9094

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Tri-Cities Nursing and Rehabilitation Center Doing business as

Electronic endpoints 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Van S Breeding, MD

  • Family Medicine Physician
  • Whitesburg, KY
  • NPI 1801841572
  NPD (past)
• Gregory Brian Dye, M.D.

  • Family Medicine Physician
  • Harlan, KY
  • NPI 1275528937
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1144256595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19101 N US HIGHWAY 119",
            "city": "CUMBERLAND",
            "state": "KY",
            "postal_code": "408238107",
            "telephone_number": "606-589-5421",
            "fax_number": "606-589-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19101 N US HIGHWAY 119",
            "city": "CUMBERLAND",
            "state": "KY",
            "postal_code": "408238107",
            "telephone_number": "606-589-5421",
            "fax_number": "606-589-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANGING ROCK LTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "BOICE",
        "authorized_official_first_name": "GALE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "252-523-9094"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12503298",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100168700",
            "state": "KY"
        }
    ],
    "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": "Tri-Cities Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tri-Cities Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donell's Tri-City Pharmacy
• Matthew Steven Duckworth
• Dustin Ferrell, PT, DPT
• Chad Fields
• Homer Richard Fortney, D.M.D.
• Daniel E. Howard, RPH
• Billie Jo Jackson, APRN
• Christopher Lewis, APRN
• Main Street Clinic, LLC
• Mountain Comprehensive Health Corporation

• Skilled Nursing Facility in Cumberland, KY
• Providers in Cumberland, 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 Jul 16, 2021; 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.