HBR Elizabethtown, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HBR ELIZABETHTOWN, LLC

Doing business as

Kensington Center

Practice address

225 Saint John Rd
Elizabethtown, KY 42701-2918

Phone

(270) 769-3314

Fax

(270) 360-1181

NPI assigned

Aug 31, 2006

Last updated

Jun 2, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

SUNBRIDGE HEALTHCARE LLCAs reported in NPPES

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

Authorized official

Name

Thomas Divittorio

Title

Cfo, Treasurer, Asst Secretary

Phone

(610) 444-6350

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kensington Center Doing business as

Part of

Northview Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sunbridge Healthcare LLC

  dba Columbia Crest Center

  • Skilled Nursing Facility
  • Moses Lake, WA
  • NPI 1982651758

  Member Of

  NPD member

Practitioners 1

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.

• Achamma S Itticheria, MD

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1942415732
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1235240383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SAINT JOHN RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012918",
            "telephone_number": "270-769-3314",
            "fax_number": "270-360-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HBR ELIZABETHTOWN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "DIVITTORIO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO, TREASURER, ASST SECRETARY",
        "authorized_official_telephone_number": "610-444-6350"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12505269",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kensington Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa J Haydon
• Mendy Dawn Hayes, NP
• Herbert Jeffrey Haynes, M.D.
• Shawna Marie Hazelton, BS
• Nancy Claycomb Hazle, M.A.
• Chanty Lynn Headspeth, PA C
• Brenda Wilcox Heady
• Healing Solutions Counseling LLC
• Health Maintenance Advantage, PLLC
• Healthcare Systems International Inc (Chiropractic Health & Fitness Systems)

• Skilled Nursing Facility in Elizabethtown, KY
• Providers in Elizabethtown, 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 2, 2015; 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.