Active NPI
Moore Healthcare Enterprises Inc
- Nursing Facility/Intermediate Care Facility
- Middletown, IN
National Provider Identifier
1619392255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 155486
- Legal business name
- MOORE HEALTHCARE ENTERPRISES INC
- Practice address
- 131 S 10TH St
Middletown, IN 47356 - Phone
- (765) 354-2223
- Fax
- (765) 354-6111
- NPI assigned
- Feb 19, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kimberly J Moore
- Title
- Owner
- Phone
- (765) 354-2223
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 155486 | IN | Primary |
Addresses
Primary practice location
131 S 10TH St
Middletown, IN 47356
Mailing address
131 S 10TH St
Middletown, IN 47356-9772
Phone (765) 354-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100289600 A | Medicaid | IN |
Other names 1
- Middletown Nursing and Rehabilitation Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130606000562 | IN | Part A Provider - Skilled Nursing Facility | 8426296211 | Practice locations: Middletown, IN |
Skilled nursing facility certification: CCN 155486
- Legal name
- MOORE HEALTHCARE ENTERPRISES INC
- Doing business as
- MIDDLETOWN NURSING AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 1, 1993
- Last certification
- Nov 26, 2024
- Beds
- 45
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Mar 25, 2013 in IN
- Enrollment address
- 131 S 10TH St
Middletown, IN 47356-9772 - Nursing home name
- MIDDLETOWN NURSING AND REHABILITATION CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Middletown Nursing and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- May 1, 1993
- Medicare certification status
- Active
- Certified beds
- 45
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Janet S Case | W-2 Managing Employee | Jun 1, 2013 | |
| Kimberly J Moore | 5% Or Greater Direct Ownership Interest | Jun 1, 2013 | 100% |
| Corporate Officer | Jun 1, 2013 | ||
| Jerrod T Moore | Operational/Managerial Control | Jun 20, 2018 | 100% |
| Moore Healthcare Enterprises Inc | 5% Or Greater Direct Ownership Interest | Jun 1, 2013 | 100% |
| Operational/Managerial Control | Jun 1, 2013 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392768000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1531440000000",
"number": "1619392255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 S 10TH ST",
"city": "MIDDLETOWN",
"state": "IN",
"postal_code": "473569772",
"telephone_number": "765-354-2223",
"fax_number": "765-354-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 S 10TH ST",
"city": "MIDDLETOWN",
"state": "IN",
"postal_code": "47356",
"telephone_number": "765-354-2223",
"fax_number": "765-354-6111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOORE HEALTHCARE ENTERPRISES INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-02-19",
"last_updated": "2018-07-13",
"status": "A",
"authorized_official_last_name": "MOORE",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "765-354-2223"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "IN",
"license": "155486",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100289600 A",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Middletown Nursing and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Middletown Nursing and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Middletown, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.