Hermitage Manor, Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

HERMITAGE MANOR, INC

Practice address

2311 S Miller St
Shelbyville, IN 46176-9350

Phone

(317) 398-9777

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Pamela Deprez

Title

Owner

Phone

(765) 521-4110

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669422804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BROAD ST",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473624228",
            "telephone_number": "765-521-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 S MILLER ST",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461769350",
            "telephone_number": "317-398-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMITAGE MANOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEPREZ",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-521-4110",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.