Diversicare of Glasgow, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100509 Issued in KY

Legal business name

DIVERSICARE OF GLASGOW, LLC

Practice address

300 Westwood St
Glasgow, KY 42141-1030

Phone

(270) 651-9131

Fax

(615) 620-7875

NPI assigned

Dec 8, 2014

Organization subpart

Yes

Parent organization

DIVERSICARE HEALTHCARE SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Kelly J Gill

Title

President and Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other names 1

• Diversicare of Glasgow Doing business as

Locations

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1558769505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WESTWOOD ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411030",
            "telephone_number": "270-651-9131",
            "fax_number": "615-620-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WESTWOOD ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411030",
            "telephone_number": "270-651-9131",
            "fax_number": "615-620-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF GLASGOW, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE HEALTHCARE SERVICES, INC.",
        "enumeration_date": "2014-12-08",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diversicare of Glasgow",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Glasgow, KY
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.