NPIMap

Organization Active NPI

Masonic Homes of Kentucky Inc

  • Skilled Nursing Facility
  • Shelbyville, KY
National Provider Identifier
1669495131
Registry record updated Dec 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
100386 Issued in KY
Legal business name
MASONIC HOMES OF KENTUCKY INC
Practice address
711 Frankfort Rd
Shelbyville, KY 40065-9447
Phone
(502) 633-3486
Fax
(502) 633-0661
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2008

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

Authorized official

Name
Mrs. Debra Finneran, R.N.
Title
Administrator
Phone
(502) 633-3486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 100386 KY Primary

Addresses

Primary practice location

711 Frankfort Rd
Shelbyville, KY 40065-9447

Mailing address

711 Frankfort Rd
P.O. Box 909
Shelbyville, KY 40065-9447
Phone (502) 633-3486

Other identifiers 4

IdentifierTypeStateIssuer
12502571MedicaidKY
000000054519OtherKYANTHEM PROVIDER NUMBER
2438960000OtherKYPASSPORT ADVANTAGE
5394544OtherKYAETNA PROVIDER NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229904000000",
    "number": "1669495131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 FRANKFORT RD",
            "address_2": "P.O. BOX 909",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400659447",
            "telephone_number": "502-633-3486",
            "fax_number": "502-633-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 FRANKFORT RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400659447",
            "telephone_number": "502-633-3486",
            "fax_number": "502-633-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONIC HOMES OF KENTUCKY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-12-22",
        "status": "A",
        "authorized_official_last_name": "FINNERAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "502-633-3486",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12502571",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000054519",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2438960000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "5394544",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; 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.