Diversicare of Nicholasville, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DIVERSICARE OF NICHOLASVILLE, LLC

Practice address

100 Sparks Ave
Nicholasville, KY 40356-1004

Phone

(859) 885-4171

Fax

(615) 620-7875

NPI assigned

May 5, 2014

Last updated

Jun 1, 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 and Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1821408394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SPARKS AVE",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403561004",
            "telephone_number": "859-885-4171",
            "fax_number": "615-620-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPARKS AVE",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403561004",
            "telephone_number": "859-885-4171",
            "fax_number": "615-620-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF NICHOLASVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE LEASING COMPANY II, LLC",
        "enumeration_date": "2014-05-05",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100323260",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Nicholasville, KY
• Providers in Nicholasville, KY by specialty
• Skilled Nursing Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.