NPIMap

Organization Active NPI

Middlesboro Manor LLC

Doing business as Middlesboro Health Care Facility

  • Skilled Nursing Facility
  • Middlesboro, KY
National Provider Identifier
1881683480
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
100639 Issued in KY
Legal business name
MIDDLESBORO MANOR LLC
Doing business as
Middlesboro Health Care Facility
Practice address
235 New Wilson LN
Middlesboro, KY 40965-2705
Phone
(606) 248-0925
Fax
(606) 242-2544
NPI assigned
Oct 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

Name
Mrs. Kimberly Morrow
Title
VP of Administrative Support
Phone
(859) 623-0898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 100639 KY Primary

Addresses

Primary practice location

235 New Wilson LN
Middlesboro, KY 40965-2705

Mailing address

300 Provider CT
Suite 100
Richmond, KY 40475-8488
Phone (859) 623-0898

Other identifiers 3

IdentifierTypeStateIssuer
12504205MedicaidKY
7100244560MedicaidKY
90160763MedicaidKY

Other names 1

  • Middlesboro Health Care Facility Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Middlesboro Health Care Facility2 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.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1881683480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PROVIDER CT",
            "address_2": "SUITE 100",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758488",
            "telephone_number": "859-623-0898",
            "fax_number": "859-623-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 NEW WILSON LN",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652705",
            "telephone_number": "606-248-0925",
            "fax_number": "606-242-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESBORO MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "VP OF ADMINISTRATIVE SUPPORT",
        "authorized_official_telephone_number": "859-623-0898",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12504205",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100244560",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90160763",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middlesboro Health Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middlesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.