NPIMap

Organization Active NPI

Avalon Home, Inc.

Doing business as Avalon Manor Health Care Center

  • Skilled Nursing Facility
  • Hagerstown, MD
National Provider Identifier
1164477089
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
21-001 Issued in MD
Legal business name
AVALON HOME, INC.
Doing business as
Avalon Manor Health Care Center
Practice address
14014 Marsh Pike
Hagerstown, MD 21742-1638
Phone
(301) 733-8700
Fax
(301) 733-8700
NPI assigned
May 23, 2006
Last updated
May 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Authorized official

Name
Marlene Kephart
Title
Business Office Manager
Phone
(301) 733-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 21-001 MD Primary

Addresses

Primary practice location

14014 Marsh Pike
Hagerstown, MD 21742-1638

Mailing address

14014 Marsh Pike
Hagerstown, MD 21742-1638
Phone (301) 733-8700

Other identifiers 5

IdentifierTypeStateIssuer
RT3OtherCAREFIRST - IND/PPO
278161OtherAMERIGROUP
RT3OtherCAREFIRST - BLUE CHOICE
02MMOtherCAREFIRST - PROV INQ#
5522258OtherAETNA-HMO

Other names 1

  • Avalon Manor Health Care Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1164477089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14014 MARSH PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421638",
            "telephone_number": "301-733-8700",
            "fax_number": "301-733-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14014 MARSH PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421638",
            "telephone_number": "301-733-8700",
            "fax_number": "301-733-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "KEPHART",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "301-733-8700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "21-001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST - IND/PPO",
            "identifier": "RT3",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "278161",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST - BLUE CHOICE",
            "identifier": "RT3",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST - PROV    INQ#",
            "identifier": "02MM",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-HMO",
            "identifier": "5522258",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Manor Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

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