NPIMap

Organization Active NPI

Kindred Hospitals East, LLC

Doing business as Kindred Hospital - Bay Area - St. Petersburg

  • Long Term Care Hospital
  • St Petersburg, FL
National Provider Identifier
1396820973
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
4457 Issued in FL
Legal business name
KINDRED HOSPITALS EAST, LLC
Doing business as
Kindred Hospital - Bay Area - St. Petersburg
Practice address
3030 6TH St S
St Petersburg, FL 33705-3720
Phone
(727) 894-8719
Fax
(727) 894-0257
NPI assigned
Oct 25, 2006
Last updated
Apr 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

Name
Johnetta Traylor
Title
Dir Licensure & Certification
Phone
(502) 596-6063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 4457 FL Primary

Addresses

Primary practice location

3030 6TH St S
St Petersburg, FL 33705-3720

Mailing address

PO Box 530631
Atlanta, GA 30353-0631
Phone (727) 894-8719

Other identifiers 2

IdentifierTypeStateIssuer
010276800MedicaidFL
Y31OtherFLBLUE CROSS

Other names 1

  • Kindred Hospital - Bay Area - St. Petersburg Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090313000289 FL Part A Provider - Hospital 0648187674 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Petersburg, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396820973. Details of each certification follow.

Hospital certification: CCN 102009

Legal name
KINDRED HOSPITALS EAST LLC
Doing business as
KINDRED HOSPITAL-BAY AREA-ST PETERSBURG
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Nov 1, 1988
Last certification
Apr 14, 2012
Beds
155
Ownership / control type
Private (for profit)
Most recent change of ownership
May 1, 1998 (2 total)
Organization structure
LLCProprietary
Enrollment address
3030 6TH St S
Saint Petersburg, FL 33705-3720
Main/Primary Hospital Location
Hospital subgroups
Long-term

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Kindred Hospital-Bay Area-TampaCCN 102009 · All quality measures
Ownership
For profit
Certified
Nov 1, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Beds
155

National Provider Directory

National Provider Directory
Tax ID family
KHP House Physcians19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kindred Healthcare Operating LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Direct Ownership Interest Mar 27, 1998 100%
Kentucky Hospital Intermediate LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%
Kindred Healthcare LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Feb 26, 1998 100%
Jacquelyn Joy Davis Individual Contracted Managing EmployeeChain Home Office Administrator Dec 16, 2023
Scott Graeser Individual Corporate OfficerVice President, Treasurer Aug 19, 2022
Jeffrey Harrison Individual Contracted Managing EmployeeMarket Ceo Jul 16, 2023
Dana M Rock Individual Corporate OfficerAssistant Administrator Dec 9, 2024
Johnetta M Traylor Individual Corporate OfficerAdministrator Dec 9, 2024
Kentucky Hospital Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%
Deanna Schiavone Individual Corporate OfficerPresident and Cfo Aug 22, 2022
Knight Health Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Michael Joseph Bean Individual Corporate OfficerVice President, Tax Dec 14, 2004
Knight Health LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Knight Intermediate Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Kentucky Hospital Holdings JV LP Organization, Louisville, KY Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%

Practitioners & affiliated clinicians

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1396820973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530631",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530631",
            "telephone_number": "727-894-8719",
            "fax_number": "727-894-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337053720",
            "telephone_number": "727-894-8719",
            "fax_number": "727-894-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED HOSPITALS EAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "DIR LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "FL",
            "license": "4457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010276800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y31",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Hospital - Bay Area - St. Petersburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindred Hospital - Bay Area - St. Petersburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.