Hermitage Healthcare of Manokin Manor, LLC

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

Legal business name

HERMITAGE HEALTHCARE OF MANOKIN MANOR, LLC

Practice address

11974 Edgehill Terrace Rd
Princess Anne, MD 21853-2105

Phone

(410) 651-0011

Fax

(410) 543-4471

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Bonnie C. Stone, LICENSED ADMINISTRAT

Title

Administrator

Phone

(410) 651-0011

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Manokin Manor Nursing & Rehab Ctr. Doing business as

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790795672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11974 EDGEHILL TERRACE RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218532105",
            "telephone_number": "410-651-0011",
            "fax_number": "410-543-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11974 EDGEHILL TERRACE RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218532105",
            "telephone_number": "410-651-0011",
            "fax_number": "410-543-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMITAGE HEALTHCARE OF MANOKIN MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-651-0011",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICENSED ADMINISTRAT"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manokin Manor Nursing & Rehab Ctr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Healthport
• Healthport
• Brittany Leigh Heffernan, D.D.S.
• Briana Henderson
• Judith Cecilia Henry, DMD,MPH
• Cynthia Ann Heselbach, RDH
• Stephanie Lynn Hewitt, LCSW-C
• Amanda Gail Hill, LGSW
• Ann T. Hill, CRNP
• Ronetta Hockday

• Pediatric Skilled Nursing Facility in Princess Anne, MD
• Providers in Princess Anne, MD by specialty
• Pediatric Skilled Nursing Facility in Maryland

• 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.