New Jefferson Manor, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100533 Issued in KY

Legal business name

NEW JEFFERSON MANOR, LLC

Doing business as

Jefferson Manor Health & Rehabilitation Center

Practice address

1801 Lynn Way
Louisville, KY 40222-6552

Phone

(502) 426-4513

Fax

(502) 426-7041

NPI assigned

Oct 14, 2005

Last updated

Apr 1, 2014By 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

Mr. Jim Morris

Title

Administrator

Phone

(502) 426-4513

Specialties & licenses 1

Addresses

Other names 1

• Jefferson Manor Health & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1295724086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LYNN WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226552",
            "telephone_number": "502-426-4513",
            "fax_number": "502-426-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LYNN WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226552",
            "telephone_number": "502-426-4513",
            "fax_number": "502-426-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JEFFERSON MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "502-426-4513",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Manor Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Louisville, KY
• Providers in Louisville, 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 Apr 1, 2014; 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.