NPIMap

Organization Active NPI

Park Manor Health and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Northport, AL
National Provider Identifier
1407803109
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PARK MANOR HEALTH AND REHABILITATION, LLC
Practice address
2201 McFarland Blvd
Northport, AL 35476-2943
Phone
(205) 339-5300
NPI assigned
May 28, 2006
Last updated
Oct 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Phillip Cody Long
Title
Cfo
Phone
(205) 391-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2201 McFarland Blvd
Northport, AL 35476-2943

Mailing address

2201 McFarland Blvd
Northport, AL 35476-2943
Phone (205) 339-5300

Other identifiers 2

IdentifierTypeStateIssuer
010689OtherALBCBS ID
4757090SMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021231000009 AL Part A Provider - Skilled Nursing Facility 5496663437 Practice locations: Northport, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407803109. Details of each certification follow.

Skilled nursing facility certification: CCN 015326

Legal name
PARK MANOR HEALTH AND REHABILITATION, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1979
Last certification
Aug 26, 2021
Beds
152
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Nov 8, 2002 in AL
Enrollment address
2201 McFarland Blvd
Northport, AL 35476-2943
Nursing home name
PARK MANOR HEALTH AND REHABILITATION, LLC
Affiliated entity
NHS MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Park Manor Health and Rehabilitation, LLCCCN 015326 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 1, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
152143.5 residents per day on average
Chain
NHS Management43 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
James Norman Estes Jr TR Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Nov 8, 2002 5.32%
Lynn S Rasco Individual Corporate DirectorDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Operational/Managerial ControlDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Park Manor Health Realty, LLC Organization, Tuscaloosa, AL LLC 5% Or Greater Security Interest Jan 1, 2003
Jennifer Lee Estes TR 031093 Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Nov 8, 2002 5.32%
James Norman Estes Individual 5% Or Greater Indirect Ownership InterestPresident/Treasurer Nov 8, 2002 89.36%
Corporate OfficerPresident/Treasurer Nov 8, 2002 100%
NHS Operations LLC Organization, Tuscaloosa, AL LLC 5% Or Greater Direct Ownership Interest Nov 8, 2002 100%
Vickie Murphy Individual W-2 Managing EmployeeAdministrator Jun 29, 2023 100%
Operational/Managerial ControlAdministrator Jun 29, 2023 100%
Phillip Cody Long Individual Corporate OfficerVice President/Secretary Oct 1, 2019
Other Jan 1, 2022 10.64%
Casey D Boyd Individual Corporate DirectorRegional Administrator Apr 28, 2023 33%
Operational/Managerial ControlRegional Administrator Apr 28, 2023 33%
Regions Bank Organization, Birmingham, AL Financial institution 5% Or Greater Security Interest Aug 27, 2012
Brandon S. Agee Individual Other Jan 1, 2022 10.64%
Marcia Duffy Individual Corporate DirectorRegional Nurse Consultant Dec 12, 2003 33%
Operational/Managerial ControlRegional Nurse Consultant Dec 12, 2003 33%
NHS Management LLC Organization, Tuscaloosa, AL LLC Other Jun 1, 2007

Facilities with the same owner 40

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 40

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 1

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": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1407803109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MCFARLAND BLVD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354762943",
            "telephone_number": "205-339-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 MCFARLAND BLVD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354762943",
            "telephone_number": "205-339-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MANOR HEALTH AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "010689",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4757090S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.