Active NPI
LP Hodgenville LLC
Doing business as Sunrise Manor Nursing Home
- Skilled Nursing Facility
- Hodgenville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 100277
- Legal business name
- LP HODGENVILLE LLC
- Doing business as
- Sunrise Manor Nursing Home
- Practice address
- 717 N Lincoln Blvd
Hodgenville, KY 42748-1622 - Phone
- (270) 358-3103
- NPI assigned
- Sep 12, 2011
- Last updated
- Apr 3, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Harrison
- Title
- Cfo
- Phone
- (502) 568-7800
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 750086 | KY | |
| Skilled Nursing Facility | 314000000X | |||
| Skilled Nursing Facility | 314000000X | 100277 | KY | Primary |
Addresses
Primary practice location
717 N Lincoln Blvd
Hodgenville, KY 42748-1622
Mailing address
717 N Lincoln Blvd
Hodgenville, KY 42748-1622
Phone (270) 358-3103
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100199630 | Medicaid | KY | |
| 7100194560 | Medicaid | KY |
Other names 1
- Sunrise Manor Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120214000837 | KY | Part A Provider - Skilled Nursing Facility | 6002088432 | Practice locations: Hodgenville, KY |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1770865263. Details of each certification follow.
Skilled nursing facility certification: CCN 185057
- Legal name
- LP HODGENVILLE LLC
- Doing business as
- SUNRISE MANOR NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 14, 1967
- Last certification
- Apr 14, 2022
- Beds
- 137
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Signature Healthcare
- Organization structure
- LLC
- Incorporated
- Apr 12, 2011 in DE
- Enrollment address
- 717 North Lincoln Blvd
Hodgenville, KY 42748-1622 - Nursing home name
- SUNRISE MANOR NURSING HOME
- Affiliated entity
- SIGNATURE HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Sunrise Manor Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 14, 1967
- Medicare certification status
- Active
- Certified beds
- 137
- Chain
- Signature Healthcare
National Provider Directory
National Provider DirectoryOwnership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Ira Smedra | 5% Or Greater Indirect Ownership Interest | Oct 1, 2011 | 12% |
| Amy Durbin | W-2 Managing Employee | Jun 13, 2023 | |
| Distinct Group Holdings, LLC | 5% Or Greater Direct Ownership Interest | May 1, 2018 | 100% |
| Signature Healthcare LLC | Operational/Managerial Control | Oct 1, 2011 | |
| Lpsnf LLC | 5% Or Greater Indirect Ownership Interest | Oct 1, 2011 | 74% |
| John H Harrison | Corporate Officer | Oct 1, 2011 | |
| Wheaten LLC | 5% Or Greater Indirect Ownership Interest | Oct 1, 2011 | 5% |
| Elmer Joseph Steier III | 5% Or Greater Indirect Ownership Interest | Oct 1, 2011 | 20% |
| Corporate Officer | Oct 1, 2011 | ||
| Operational/Managerial Control | Apr 12, 2011 | ||
| Jjla LLC | 5% Or Greater Indirect Ownership Interest | Oct 1, 2011 | 20% |
Facilities with the same owner 64
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Clinton County Care & Rehabilitation Center
- Skilled Nursing Facility
- Albany, KY
- NPI 1437340700
Jjla LLC, Wheaten LLC
-
dba Signature Healthcare at Jackson Manor Rehab & Wellness Center
- Skilled Nursing Facility
- Annville, KY
- NPI 1760853725
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Signature Healthcare at Colonial Rehab & Wellness Center
- Skilled Nursing Facility
- Bardstown, KY
- NPI 1548631070
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Lee County Care & Rehabilitation Center
- Skilled Nursing Facility
- Beattyville, KY
- NPI 1255522520
Jjla LLC, Signature Healthcare LLC, Wheaten LLC
-
dba Signature HealthCARE of Bowling Green
- Skilled Nursing Facility
- Bowling Green, KY
- NPI 1447674437
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Rockcastle Health and Rehabilitation Center
- Skilled Nursing Facility
- Brodhead, KY
- NPI 1609053735
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Riverside Care & Rehabilitation Center
- Skilled Nursing Facility
- Calhoun, KY
- NPI 1932523602
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Oakview Nursing & Rehabilitation Center
- Skilled Nursing Facility
- Calvert City, KY
- NPI 1619218385
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Signature Healthcare of Carrollton Rehab & Wellness Center
- Skilled Nursing Facility
- Carrollton, KY
- NPI 1134599525
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Signature Healthcare at Summit Manor Rehab & Wellness Center
- Skilled Nursing Facility
- Columbia, KY
- NPI 1255701397
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Danville Centre for Health & Rehabilitation
- Skilled Nursing Facility
- Danville, KY
- NPI 1992129613
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Signature HealthCARE of Elizabethtown
- Skilled Nursing Facility
- Elizabethtown, KY
- NPI 1922422690
Jjla LLC, Lpsnf LLC, Signature Healthcare LLC, Wheaten LLC
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1689754822
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1689754822
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680480000000",
"number": "1770865263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 N LINCOLN BLVD",
"city": "HODGENVILLE",
"state": "KY",
"postal_code": "427481622",
"telephone_number": "270-358-3103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 N LINCOLN BLVD",
"city": "HODGENVILLE",
"state": "KY",
"postal_code": "427481622",
"telephone_number": "270-358-3103"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LP HODGENVILLE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-12",
"last_updated": "2023-04-03",
"certification_date": "2023-04-03",
"status": "A",
"authorized_official_last_name": "HARRISON",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "502-568-7800"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "KY",
"license": "750086",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "KY",
"license": "100277",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100199630",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100194560",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sunrise Manor Nursing Home",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Sunrise Manor Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hodgenville, KY
- Mariah Lavere
- Lincoln Trail District Health Department (LaRue County Health Center)
- Lincoln Way LLC Janice Diane Haycraft Single MBR
- Louisville Optometric Centers, III PSC (VisionFirst)
- Louisville Optometric Centers, III PSC (VisionFirst)
- Kevin G Malison, D.D.S
- Midwest Psychologists, PLLC
- Jetona K Milby, LMFT
- Susan D Mings, LCSW
- Wesley Moore, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.