Kingston Health Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

068502 Issued in PA

Legal business name

KINGSTON HEALTH CARE CENTER LLC

Doing business as

Kingston Health Care Center

Practice address

702 3Rd Ave
Kingston, PA 18704-5845

Phone

(570) 283-5848

Fax

(570) 383-5152

NPI assigned

Sep 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Michael P Kelly

Title

Managing Member

Phone

(570) 969-2188

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kingston Health Care Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Kingston Health Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kingston SNF Healthcare, LLC

  • Skilled Nursing Facility
  • Kingston, PA
  • NPI 1194145706
  NPD tax ID

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1811983687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MOLTKE AVE",
            "address_2": "SUITE 100",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052886",
            "telephone_number": "570-969-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 3RD AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045845",
            "telephone_number": "570-283-5848",
            "fax_number": "570-383-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSTON HEALTH CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "570-969-2188",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "068502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102787826-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingston Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Kile, MSOT, OTR/L
• Chull Soo Kim, PH.D, TCM ., O.M.D.
• Kingston Chiropractic LLC
• Kingston Community Pharmacy Inc.
• Kingston Firemens Community Ambulance
• Kingston Operations LLC
• Kingston Ophthalmology ASC LLC
• Kingston Ophthalmology ASC LLC
• Kingston SNF Healthcare, LLC
• Kingston SNF Operations, LLC

• Skilled Nursing Facility in Kingston, PA
• Providers in Kingston, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.