Diversicare of Bradford Place, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DIVERSICARE OF BRADFORD PLACE, LLC

Practice address

1302 Millville Ave
Hamilton, OH 45013-3961

Phone

(513) 867-4100

Fax

(513) 867-1415

NPI assigned

Sep 11, 2013

Organization subpart

Yes

Parent organization

DIVERSICARE LEASING COMPANY II, LLCAs reported in NPPES

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

Authorized official

Name

James R. McKnight Jr.

Title

President & Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Diversicare of Bradford Place Doing business as

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1508291329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 MILLVILLE AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450133961",
            "telephone_number": "513-867-4100",
            "fax_number": "513-867-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 MILLVILLE AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450133961",
            "telephone_number": "513-867-4100",
            "fax_number": "513-867-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF BRADFORD PLACE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE LEASING COMPANY II, LLC",
        "enumeration_date": "2013-09-11",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "615-771-7575",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096324",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diversicare of Bradford Place",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diversicare of Bradford Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Dingledine, LISW
• David Robert Dinuoscio, M.D.
• Isabella Melissa Disalvo, CDCA 1
• Browyn Dishun
• Melinda Ditmer
• Diversicare of Bradford Place, LLC
• Russell Dean Dixon
• Brandy R Doerr
• Margaret Dole
• Erika K Dollard, PA-C

• Skilled Nursing Facility in Hamilton, OH
• Providers in Hamilton, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.