Parkside Manor LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

100168 Issued in KY

Legal business name

PARKSIDE MANOR LLC

Practice address

317 Oddville Avenue
Suite B
Cynthiana, KY 41031

Phone

(859) 234-4430

Fax

(859) 234-4438

NPI assigned

Aug 4, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Kelli Lynn Bailey

Title

Owner/Administrator

Phone

(859) 234-4430

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249344000000",
    "number": "1386875656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 ODDVILLE AVENUE",
            "address_2": "SUITE B",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "41031",
            "telephone_number": "859-234-4430",
            "fax_number": "859-234-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 ODDVILLE AVENUE",
            "address_2": "SUITE B",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "41031",
            "telephone_number": "859-234-4430",
            "fax_number": "859-234-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-04",
        "last_updated": "2009-08-04",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "859-234-4430",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "KY",
            "license": "100168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Henry Norfleet, MD
• Janet Olson
• Anna L Otis, MSW, CSW
• Parke Physicians PLLC
• Parkside Manor I LLC
• Jeremy Lee Penn, OD
• John Francis Peppin, D.O.
• James Pettey, MD
• John Pidakala, MD
• Sofie Lavinia Pinney, DPM

• All providers in Cynthiana, KY
• Custodial Care Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.