Extendicare, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N3501 Issued in AL

Legal business name

EXTENDICARE, INC

Practice address

950 S Saint Andrews St
Dothan, AL 36301-3684

Phone

(334) 793-1177

Fax

(334) 699-3948

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

David Dennis

Title

Ceo

Phone

(334) 793-1177

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse E Morriss III, MD

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1063481273
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1487669115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 391",
            "address_2": "104 APPLE AVE SUITE 3",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36303",
            "telephone_number": "334-793-1177",
            "fax_number": "334-699-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S SAINT ANDREWS ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013684",
            "telephone_number": "334-793-1177",
            "fax_number": "334-699-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDICARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-02-29",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-793-1177"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "N3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4757020S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Anthony Eubanks Jr., MSPT, OCS
• Clinton Wilkinson Evans, M.D., D.M.D.
• David H Evans, MD
• John Evans Jr., NURSE PRACTITIONER
• Extended Care Medical Associates LLC
• Eye Care Associates of the Southeast, P.C.
• Eye Doctors Office, Inc
• Eye Partners PC
• Eye Partners PC
• Eye Partners, PC

• Skilled Nursing Facility in Dothan, AL
• Providers in Dothan, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.