Portland Nursing & Rehab Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0000000270 Issued in TN

Legal business name

PORTLAND NURSING & REHAB CENTER, INC.

Practice address

215 Highland Circle Dr
Portland, TN 37148-4918

Phone

(615) 325-9263

Fax

(615) 325-5776

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. David Rodman

Title

Asst. Secretary

Phone

(407) 975-3011

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Highland Manor Nursing & Rehab Center Doing business as

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1740319664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 COURTLAND ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328041360",
            "telephone_number": "407-975-3000",
            "fax_number": "407-975-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HIGHLAND CIRCLE DR",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371484918",
            "telephone_number": "615-325-9263",
            "fax_number": "615-325-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND NURSING & REHAB CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "RODMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ASST. SECRETARY",
        "authorized_official_telephone_number": "407-975-3011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744-0308",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454187",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044-5306",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Manor Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Poghen, APRN
• Laura Porter-Guyer, PA
• Paul R. Porter, M.D.
• Portland Clinic Pharmacy
• Portland Medical
• Portland Prescription Shop PLLC
• Portland Primary Care LLC
• Portland Primary Care, LLC
• Portland Surgical, LLC
• Portland Wellness Center PLLC

• All providers in Portland, TN
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.