Maysville Manor LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100333 Issued in KY

Legal business name

MAYSVILLE MANOR LLC

Doing business as

Maysville Extended Care Facility

Practice address

620 Parker Rd
Maysville, KY 41056-9620

Phone

(606) 564-4085

Fax

(606) 564-8835

NPI assigned

Oct 17, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Morrow

Title

VP of Administrative Support

Phone

(859) 623-0898

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Maysville Extended Care Facility Doing business as

Locations

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1457340051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PROVIDER CT",
            "address_2": "SUITE 100",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758488",
            "telephone_number": "859-623-0898",
            "fax_number": "859-623-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PARKER RD",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569620",
            "telephone_number": "606-564-4085",
            "fax_number": "606-564-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYSVILLE MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "VP OF ADMINISTRATIVE SUPPORT",
        "authorized_official_telephone_number": "859-623-0898",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12501292",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90160763",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maysville Extended Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Maysville, KY
• Providers in Maysville, KY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.