NPIMap

Organization Active NPI

Plaquemine Manor Nursing Home, Inc.

  • Skilled Nursing Facility
  • Plaquemine, LA
National Provider Identifier
1881746204
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
106 Issued in LA
Legal business name
PLAQUEMINE MANOR NURSING HOME, INC.
Practice address
24320 Ferdinand St
Plaquemine, LA 70764-3634
Phone
(225) 387-1345
Fax
(225) 687-4778
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Bob G. Dean Jr.
Title
President
Phone
(225) 343-9152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 106 LA Primary

Addresses

Primary practice location

24320 Ferdinand St
Plaquemine, LA 70764-3634

Mailing address

24320 Ferdinand St
Plaquemine, LA 70764-3634
Phone (225) 387-1345

Other identifiers 1

IdentifierTypeStateIssuer
51773MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881746204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24320 FERDINAND ST",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707643634",
            "telephone_number": "225-387-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24320 FERDINAND ST",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707643634",
            "telephone_number": "225-387-1345",
            "fax_number": "225-687-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAQUEMINE MANOR NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "BOB",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-343-9152",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51773",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plaquemine, LA

Sources for this page

  • 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.