NPIMap

Organization Active NPI

Rollins Bedford Corporation

Doing business as Leitchfield Health Care Manor

  • Skilled Nursing Facility
  • Leitchfield, KY
National Provider Identifier
1285852954
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
100149 Issued in KY
Legal business name
ROLLINS BEDFORD CORPORATION
Doing business as
Leitchfield Health Care Manor
Practice address
718 Goodwin LN
Leitchfield, KY 42754-1400
Phone
(270) 259-4036
Fax
(270) 259-3205
NPI assigned
Apr 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ronald M Wehtje
Title
VP Cfo
Phone
(407) 975-3010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 100149 KY Primary

Addresses

Primary practice location

718 Goodwin LN
Leitchfield, KY 42754-1400

Mailing address

602 Courtland St
Suite 200
Orlando, FL 32804-1360
Phone (407) 975-3000

Other identifiers 2

IdentifierTypeStateIssuer
12504114MedicaidKY
90003930MedicaidKY

Other names 1

  • Leitchfield Health Care Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Leitchfield Health Care Manor4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285852954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 COURTLAND ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328041360",
            "telephone_number": "407-975-3000",
            "fax_number": "407-975-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 GOODWIN LN",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541400",
            "telephone_number": "270-259-4036",
            "fax_number": "270-259-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLINS BEDFORD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEHTJE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP CFO",
        "authorized_official_telephone_number": "407-975-3010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12504114",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90003930",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leitchfield Health Care Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leitchfield, KY

Sources for this page

  • 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.