NPIMap

Organization Active NPI

Kindred Hospitals East, LLC

Doing business as Kindred Hospital Philadelphia - Havertown

  • Long Term Care Hospital
  • Havertown, PA
National Provider Identifier
1235333089
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
KINDRED HOSPITALS EAST, LLC
Doing business as
Kindred Hospital Philadelphia - Havertown
Practice address
2000 Old West Chester Pike
Havertown, PA 19083-2712
Phone
(610) 853-2572
Fax
(610) 853-2575
NPI assigned
Jun 14, 2007
Last updated
Jun 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Johnetta Traylor
Title
Ao
Phone
(502) 596-6063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X NU Primary

Addresses

Primary practice location

2000 Old West Chester Pike
Havertown, PA 19083-2712

Mailing address

680 S 4TH St
Louisville, KY 40202-2407
Phone (502) 596-6063

Other names 1

  • Kindred Hospital Philadelphia - Havertown Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071115000255 PA Part A Provider - Hospital 0648187674 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Havertown, PA; Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235333089. Details of each certification follow.

Hospital certification: CCN 392027

Legal name
KINDRED HOSPITALS EAST LLC
Doing business as
KINDRED HOSPITAL - PHILADELPHIA
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Oct 1, 1995
Last certification
Apr 3, 2017
Beds
52 (46 certified)
Ownership / control type
Private (for profit)
Most recent change of ownership
Oct 1, 1998 (1 total)
Organization structure
LLCProprietary
Enrollment address
6129 Palmetto St
Philadelphia, PA 19111-5729
Main/Primary Hospital Location
Hospital subgroups
Long-term

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Kindred Hospital PhiladelphiaCCN 392027 · All quality measures
Ownership
For profit
Certified
Oct 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Beds
52

National Provider Directory

National Provider Directory
Tax ID family
Vencor Hospital Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kindred Healthcare Operating LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Direct Ownership Interest Aug 23, 2007 100%
Kentucky Hospital Intermediate LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%
Kindred Healthcare LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Aug 23, 2007 100%
Scott Graeser Individual Corporate OfficerVice President, Treasurer Aug 19, 2022
Michael L. Moody Individual Corporate OfficerPresident Jan 21, 2022
Andrew Donet Individual W-2 Managing EmployeeCeo/Hospital Administrator Jul 14, 2023
Dana M Rock Individual Corporate OfficerAssistant Administrator Dec 9, 2024
Johnetta M Traylor Individual Corporate OfficerAdministrator Dec 9, 2024
Kentucky Hospital Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%
Deanna Schiavone Individual Corporate OfficerChief Financial Officer Aug 22, 2022
Knight Health Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Michael Joseph Bean Individual Corporate Officer Mar 19, 2019
Knight Health LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Knight Intermediate Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Richard L Algood Individual Corporate OfficerSr. Vice President, Reimbursement Jul 18, 2015
Other Jul 18, 2015
Kentucky Hospital Holdings JV LP Organization, Louisville, KY Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 12

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1235333089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OLD WEST CHESTER PIKE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832712",
            "telephone_number": "610-853-2572",
            "fax_number": "610-853-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED HOSPITALS EAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Hospital Philadelphia - Havertown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindred Hospital Philadelphia - Havertown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Havertown, PA

Sources for this page

Verify at the official NPI Registry.