Kimberly Health Systems

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

06-116 Issued in WY

Legal business name

KIMBERLY HEALTH SYSTEMS

Doing business as

Michael Manor

Practice address

1108 Birch St
Douglas, WY 82633-2761

Phone

(307) 358-3397

NPI assigned

Aug 10, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Beverly J Wilson, RN

Title

Administrator/Owner

Phone

(307) 358-3397

Specialties & licenses 1

Addresses

Other names 1

• Michael Manor Doing business as

Locations

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255332383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 BIRCH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332761",
            "telephone_number": "307-358-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 BIRCH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332761",
            "telephone_number": "307-358-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "307-358-3397",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WY",
            "license": "06-116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gretchen Kassner, BS
• Alexandra Nicole Keeler, DDS
• Robert D Keeler, D.C.
• Alexander Micheal Kendall
• Ryker Michiel Kiel, DO
• Janae Kinikin, RDN
• Christine M Kirby
• Tiffany Rose Knighten, CMT
• Shauna R Kohler, MS CRNA
• W Scott Kreycik, D.D.S.

• Skilled Nursing Facility in Douglas, WY
• Providers in Douglas, WY by specialty
• Skilled Nursing Facility in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.