Elizabethtown Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ELIZABETHTOWN OPCO LLC

Doing business as

Elizabethtown Nursing and Rehabilitation Center

Practice address

1101 Woodland Dr
Elizabethtown, KY 42701-2749

Phone

(270) 765-6106

Fax

(270) 737-6690

NPI assigned

Oct 2, 2018

Last updated

Sep 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Moshe Kelman

Title

Managing Member

Phone

(270) 765-6106

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Elizabethtown Nursing and Rehabilitation Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689159972. Details of each certification follow.

• CCN 185266 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 185266

Legal name

ELIZABETHTOWN OPCO LLC

Doing business as

ELIZABETHTOWN NURSING AND REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 29, 1991

Last certification

Aug 29, 2024

Beds

65

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Apr 27, 2018 in KY

Enrollment address

1101 Woodland Dr
Elizabethtown, KY 42701-2749

Nursing home name

ELIZABETHTOWN NURSING AND REHABILITATION CENTER

Affiliated entity

BENJAMIN LANDA

Listed as

Elizabethtown Nursing and Rehabilitation CenterCCN 185266 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

May 29, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6558.3 residents per day on average

Chain

Benjamin Landa48 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 9

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

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.

• Leon Everett Butler Jr., M.D.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1689754822
  NPD (past)
• Omari Chubinidze, MD

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1669524096
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Marlon R Chagua, M.D.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1407811870

  Nursing home

  Care Compare affiliation
• Omari Chubinidze, MD

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1669524096

  Nursing home

  Care Compare affiliation
• Crysta Devine, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1457009169

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1689159972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 WOODLAND DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012749",
            "telephone_number": "270-765-6106",
            "fax_number": "270-737-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WOODLAND DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012749",
            "telephone_number": "270-765-6106",
            "fax_number": "270-737-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETHTOWN OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "KELMAN",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "270-765-6106"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "100161",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100578240",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.elizabethtownnursingandrehab.com/",
            "affiliation": "N",
            "address_1": "1101 Woodland Dr",
            "city": "Elizabethtown",
            "state": "KY",
            "country_code": "US",
            "postal_code": "427012749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Elizabethtown Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elizabethtown Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Skilled Nursing Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.

Verify at the official NPI Registry.