Gainesville Manor

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

100066 Issued in KY

Legal business name

GAINESVILLE MANOR

Practice address

550 Moores Dr
Hopkinsville, KY 42240

Phone

(270) 886-0258

NPI assigned

Mar 18, 2008

Last updated

Mar 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ida Woodard

Title

Administrator

Phone

(270) 886-0258

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1881865863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MOORES DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "42240",
            "telephone_number": "270-886-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MOORES DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "42240",
            "telephone_number": "270-886-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "IDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "270-886-0258"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "KY",
            "license": "100066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresenius Medical Care Hopkinsville, LLC (Fresenius Medical Care Hopkinsville Home Therapies)
• Samantha Frye
• Shakeira Frye
• Kecia Fulcher
• Joseph Terry Fuqua, M.D.
• Gajera & Patel PLLC
• Ratilal G Gajera, M.D.
• Panagiotis Galanopoulos, M.D.
• Amber R Galland, LPCC
• Kathy Gallaway, AGACNP-BC

• Custodial Care Facility in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Custodial Care Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.