Kindred Nursing Centers West, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI-338 Issued in AZ

Legal business name

KINDRED NURSING CENTERS WEST, LLC

Doing business as

Kindred Nursing and Rehabilitation-Hacienda

Practice address

660 S Coronado Dr
Sierra Vista, AZ 85635-3386

Phone

(520) 459-4900

Fax

(520) 458-4082

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Marilyn A. Weaver

Title

Assistant Secretary

Phone

(502) 596-7563

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Kindred Nursing and Rehabilitation-Hacienda Doing business as

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511913600000",
    "number": "1508943283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST # KH-2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S CORONADO DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353386",
            "telephone_number": "520-459-4900",
            "fax_number": "520-458-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED NURSING CENTERS WEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-11-29",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7563",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY CARE",
            "identifier": "633489",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD AZ",
            "identifier": "AZ0207100",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "266354",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "633489",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COCHISE HEALTH",
            "identifier": "633489",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APIPA",
            "identifier": "633489",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Nursing and Rehabilitation-Hacienda",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Theresa J Kibler, RDH
• Anton Kiefer, RN, BSN
• Eva-Marie Darlene Kiley, MT
• Rita Kilgore, MD
• Kimberly L Kimble, PHARMD
• Kindred Nursing Rehabilitation Hacienda
• Kindred- Hacienda
• Melissa Ann King-Marvin, LPC
• Rhonda Christine Kingman, HIS
• Andrea Shea Kissinger, CRT, RRT

• Skilled Nursing Facility in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.