1300 Campbell Lane Operating Company LLC

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

License

100655 Issued in KY

Legal business name

1300 CAMPBELL LANE OPERATING COMPANY LLC

Doing business as

Southern Kentucky Rehabilitation Hospital

Practice address

1300 Campbell LN
Bowling Green, KY 42104-4162

Phone

(270) 782-6900

Fax

(270) 782-7228

NPI assigned

May 22, 2006

Last updated

Sep 6, 2023By 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. Brad Eugene Hollinger

Title

President

Phone

(717) 591-5700

Specialties & licenses 1

Addresses

Other names 1

• Southern Kentucky Rehabilitation Hospital Doing business as

Locations

Practitioners 2

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.

• James Robert Farrage Jr., M.D.

  • Physical Medicine & Rehabilitation Physician
  • Bowling Green, KY
  • NPI 1538237391
  NPD (past)
• James Peter Little, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Chattanooga, TN
  • NPI 1134218100
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1295789295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26657",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937296657",
            "telephone_number": "559-892-2500",
            "fax_number": "559-892-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CAMPBELL LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044162",
            "telephone_number": "270-782-6900",
            "fax_number": "270-782-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1300 CAMPBELL LANE OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "HOLLINGER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-591-5700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "KY",
            "license": "100655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Kentucky Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Kentucky Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rehabilitation Hospital in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Rehabilitation Hospital in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.