Diversicare Paris, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

127763 Issued in TX

Legal business name

DIVERSICARE PARIS, LLC

Doing business as

Brentwood Terrace Healthcare and Rehabilitation Center

Practice address

2885 Stillhouse Rd
Paris, TX 75462-2042

Phone

(903) 784-4111

Fax

(903) 784-7121

NPI assigned

Oct 2, 2007

Last updated

Aug 4, 2012By the provider in NPPES

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

Kelly J Gill

Title

President and Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brentwood Terrace Healthcare and Rehabilitation Center Doing business as

Member of 1

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

• Diversicare Leasing LP

  dba Diversicare of Martin

  • Skilled Nursing Facility
  • Martin, TN
  • NPI 1538157664

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344038400000",
    "number": "1235326349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 STILLHOUSE RD",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754622042",
            "telephone_number": "903-784-4111",
            "fax_number": "903-784-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885 STILLHOUSE RD",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754622042",
            "telephone_number": "903-784-4111",
            "fax_number": "903-784-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE PARIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCAT INC.",
        "enumeration_date": "2007-10-02",
        "last_updated": "2012-08-04",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "127763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SNF",
            "identifier": "67-6045",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Terrace Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Daryl Dickey, MD
• Digestive Disease Center
• Digital Mammography of NE Texas, LTD
• Charles Udo Nnamdi Dike, BPHARM
• Chad Alan Dilbeck, PHARM.D.
• Dogwood Gynecology
• Mindy Nicole Dority, PT
• Dr Tracy Pipkin MD PA
• Dr. Tracy Pipkin MD PA
• Delaney Drake

• Skilled Nursing Facility in Paris, TX
• Providers in Paris, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2012; 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.