Lexington Manor Nursing Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

614 Issued in MS

Legal business name

LEXINGTON MANOR NURSING CENTER LLC

Practice address

56 Rockport Rd
Lexington, MS 39095-5166

Phone

(662) 834-3021

Fax

(662) 834-4848

NPI assigned

Dec 6, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Tina L Ellis

Title

Comptroller

Phone

(601) 304-0980

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700860426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 ROCKPORT RD",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "390955166",
            "telephone_number": "662-834-3021",
            "fax_number": "662-834-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 ROCKPORT RD",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "390955166",
            "telephone_number": "662-834-3021",
            "fax_number": "662-834-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON MANOR NURSING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "601-304-0980",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00230164",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John D. Whitehead
• Amy Chapman Johnson, FNP-BC
• Samuel Reid Lester, DMD
• Lexington Dental, PLLC
• Lexington Discount Pharmacy
• Lexington Manor Senior Care LLC
• Lexington Primary Care
• Lexington Rural Heath Clinic
• Shelby Lipe, NP
• Leslee S Loden, OTR/L

• All providers in Lexington, MS
• Skilled Nursing Facility in Mississippi

• 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.