Knollwood Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N4926 Issued in AL

Legal business name

KNOLLWOOD HEALTHCARE LLC

Doing business as

Gordon Oaks Healthcare Center

Practice address

3151 Knollwood Dr # a
Mobile, AL 36693-2753

Phone

(251) 661-7608

NPI assigned

Jan 16, 2008

Organization subpart

Yes

Parent organization

BRENTWOOD HEALTHCARE HOLDINGS LLCAs reported in NPPES

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

Authorized official

Name

Tygh Brogdon

Title

Manager

Phone

(770) 650-8773

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gordon Oaks Healthcare Center Doing business as

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1770769119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 KNOLLWOOD DR # A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366932753",
            "telephone_number": "251-661-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 KNOLLWOOD DR # A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366932753",
            "telephone_number": "251-661-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOLLWOOD HEALTHCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRENTWOOD HEALTHCARE HOLDINGS LLC",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "BROGDON",
        "authorized_official_first_name": "TYGH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-650-8773"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "N4926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47579902",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gordon Oaks Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Parath Knight
• Robert Clifton Knizley Jr., MD
• Olivia Margaret Knoll, MD
• Knollwood Dental Group
• Knollwood Healthcare and Rehab LLC.
• Knollwood NH LLC
• Aimee Knott
• Brandy Renee Knowles
• Carmen Knowles
• Kurt J Knowles, MD

• Skilled Nursing Facility in Mobile, AL
• Providers in Mobile, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.