Diversicare of Worland, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DIVERSICARE OF WORLAND, LLC

Doing business as

Diversicare of Worland

Practice address

1901 Howell Ave
Worland, WY 82401-3733

Phone

(307) 347-4285

Fax

(615) 620-7875

NPI assigned

May 23, 2015

Last updated

May 23, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

DIVERSICARE LEASING COMPANY II, LLCAs reported in NPPES

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

Authorized official

Name

Kelly J Gill

Title

President & Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other names 1

• Diversicare of Worland Doing business as

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

{
    "created_epoch": "1432339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432339200000",
    "number": "1750760716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 HOWELL AVE",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824013733",
            "telephone_number": "307-347-4285",
            "fax_number": "615-620-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HOWELL AVE",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824013733",
            "telephone_number": "307-347-4285",
            "fax_number": "615-620-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF WORLAND, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE LEASING COMPANY II, LLC",
        "enumeration_date": "2015-05-23",
        "last_updated": "2015-05-23",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diversicare of Worland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrea Kay Dannar, LPC
• Daza Medical Consulting Service PC
• Stacey Decroo, BS
• Holly Dial, R.N.
• Pamela Dickhaus
• James Donahue
• Michelle Ann Doyle, OTR/L
• Linda S Drumm
• Ignacio Duran Jr.
• Maria Eastman

• Skilled Nursing Facility in Worland, WY
• Providers in Worland, WY by specialty
• Skilled Nursing Facility in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2015; 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.