Diversicare Leasing Corp.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100689 Issued in KY

Legal business name

DIVERSICARE LEASING CORP.

Doing business as

Boyd Nursing & Rehabilitation Center

Practice address

12800 Princeland Dr
Ashland, KY 41102-9681

Phone

(606) 928-2963

Fax

(606) 928-3879

NPI assigned

Oct 11, 2005

Organization subpart

Yes

Parent organization

ADVOCAT INC.As reported in NPPES

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

Authorized official

Name

Raymond L. Tyler Jr.

Title

Executive Vice President and Coo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Boyd Nursing & Rehabilitation Center Doing business as

Locations

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1174511398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 PRINCELAND DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411029681",
            "telephone_number": "606-928-2963",
            "fax_number": "606-928-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 PRINCELAND DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411029681",
            "telephone_number": "606-928-2963",
            "fax_number": "606-928-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE LEASING CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCAT INC.",
        "enumeration_date": "2005-10-11",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND COO",
        "authorized_official_telephone_number": "615-771-7575",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12503082",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boyd Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jolinda R Dillow, M.D.
• Margie Dillow, LCSW
• Brooke Anna Dingess, CRNA
• Dean Dippolito, LPCC
• Jack Foster Ditty Jr., M.D.
• Grace Ann Dixon, M.D.
• Justin Kevin Dixon, M.D.
• Timothy K Dixon, MD
• Stephen Dockins, DO
• David William Dockray, M.D.

• Skilled Nursing Facility in Ashland, KY
• Providers in Ashland, 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 Nov 4, 2009; 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.