Organization Active NPI

LP Taylorsville LLC

Doing business as Signature HealthCARE of Spencer County

  • Skilled Nursing Facility
  • Taylorsville, KY
National Provider Identifier
1679764955
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
100603 Issued in KY
Legal business name
LP TAYLORSVILLE LLC
Doing business as
Signature HealthCARE of Spencer County
Practice address
625 Taylorsville Rd
Taylorsville, KY 40071-7798
Phone
(502) 477-8838
Fax
(502) 477-2273
NPI assigned
Aug 5, 2007
Last updated
Apr 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LP CS HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
Mr. John Harrison
Title
Cfo
Phone
(502) 568-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 100603 KY Primary

Addresses

Primary practice location

625 Taylorsville Rd
Taylorsville, KY 40071-7798

Mailing address

12201 Bluegrass Pkwy
Louisville, KY 40299-2361
Phone (502) 568-7800

Other names 1

  • Signature HealthCARE of Spencer County Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071019000477 KY Part A Provider - Skilled Nursing Facility 3476649518 Practice locations: Taylorsville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679764955. Details of each certification follow.

Skilled nursing facility certification: CCN 185327

Legal name
LP TAYLORSVILLE LLC
Doing business as
SIGNATURE HEALTHCARE OF SPENCER COUNTY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1992
Last certification
Aug 2, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Signature Healthcare
Organization structure
LLCProprietary
Incorporated
Nov 6, 2006 in DE
Enrollment address
625 Taylorsville Rd
Taylorsville, KY 40071-7798
Nursing home name
SIGNATURE HEALTHCARE OF SPENCER COUNTY
Affiliated entity
SIGNATURE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Signature Healthcare of Spencer CountyCCN 185327 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12093.2 residents per day on average
Chain
Signature Healthcare67 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0322343Signature Healthcare of Spencer County625 Taylorsville Road, Taylorsville, KY 40071Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ira Smedra Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2007 12%
Agemo Holdings LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 100%
LP CS Holdings LLC Organization, Louisville, KY LLC 5% Or Greater Direct Ownership Interest Nov 1, 2007 100%
Mmichele Davis Individual W-2 Managing EmployeeAdministrator Oct 24, 2022
Lpsnf II LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 74%
Signature Healthcare LLC Organization, Louisville, KY LLC Other May 7, 2018
John H Harrison Individual Corporate OfficerCfo Nov 1, 2007
Wheaten LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 5%
Elmer Joseph Steier III Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2007 20%
Jjla LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 20%

Facilities with the same owner 64

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 64

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1679764955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800",
            "fax_number": "502-568-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 TAYLORSVILLE RD",
            "city": "TAYLORSVILLE",
            "state": "KY",
            "postal_code": "400717798",
            "telephone_number": "502-477-8838",
            "fax_number": "502-477-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP TAYLORSVILLE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LP CS HOLDINGS LLC",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-568-7800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature HealthCARE of Spencer County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Signature HealthCARE of Spencer County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylorsville, KY

Sources for this page

Verify at the official NPI Registry.