Kenwood Manor LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2406-2406 Issued in OK

Legal business name

KENWOOD MANOR LLC

Practice address

502 W Pine Ave
Enid, OK 73701-3032

Phone

(580) 233-2722

NPI assigned

Nov 20, 2006

Last updated

Sep 8, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

KENWOOD MANOR LLCAs reported in NPPES

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

Authorized official

Name

Micheline Nader

Title

Owner

Phone

(918) 786-2276

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Kenwood Manor LLC

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1346314572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W PINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013032",
            "telephone_number": "580-233-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W PINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013032",
            "telephone_number": "580-233-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENWOOD MANOR LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENWOOD MANOR LLC",
        "enumeration_date": "2006-11-20",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "NADER",
        "authorized_official_first_name": "MICHELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-786-2276"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH2406-2406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200059530A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Kennedy, MCP, LPC
• John W Kennedy, RPH
• Lillie Kenner
• Kenneth L Watts MD PC
• Sarah Kent, LPN
• Kenyon Chiropractic P.C.
• Arnold W. Kenyon, D.C
• Gary Kester, CO
• James Ketterman, CRNA
• David M Keuchel, DO

• Skilled Nursing Facility in Enid, OK
• Providers in Enid, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.