NPIMap

Organization Active NPI

LP Louisville South LLC

  • Skilled Nursing Facility
  • Louisville, KY
National Provider Identifier
1891986170
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
100452 Issued in KY
Legal business name
LP LOUISVILLE SOUTH LLC
Practice address
1120 Cristland Rd
Louisville, KY 40214-4150
Phone
(502) 367-0104
Fax
(502) 368-5208
NPI assigned
Aug 5, 2007
Organization subpart
Yes
Parent organization
LP CR HOLDINGS LLCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Mr. John Harrison
Title
Cfo
Phone
(502) 568-7800

Facilities with the same owner 64

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 64

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Signature Healthcare of South LouisvilleCCN 185335
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 29, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10095.1 residents per day on average
Chain
Signature Healthcare67 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0321580LP Louisville South, LLC Dba1120 Cristland Rd, Louisville, KY 40214Certificate of waiverAug 31, 2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Skilled nursing facility certification: CCN 185335

Medicare enrollment files
Legal name
LP LOUISVILLE SOUTH LLC
Doing business as
SIGNATURE HEALTHCARE OF SOUTH LOUISVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 29, 1992
Last certification
Jan 23, 2025
Beds
100
Ownership / control type
Corporation
Multi-facility organization
Signature Healthcare
Organization structure
LLCProprietary
Incorporated
Nov 8, 2006 in DE
Enrollment address
1120 Cristland Rd
Louisville, KY 40214-4150
Nursing home name
SIGNATURE HEALTHCARE OF SOUTH LOUISVILLE
Affiliated entity
SIGNATURE HEALTHCARE

All disclosed owners & managing parties 10

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tyra Little Individual W-2 Managing EmployeeAdministrator Oct 30, 2023
Ira Smedra Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2007 12%
Agemo Holdings LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2016 100%
Lpsnf II LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2016 74%
Signature Healthcare LLC Organization, Louisville, KY Operational/Managerial Control May 7, 2018
John H Harrison Individual Corporate OfficerCfo Nov 1, 2007
Wheaten LLC Organization, Los Angeles, CA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 5%
Elmer Joseph Steier III Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2007 20%
LP CR Holdings LLC Organization, Louisville, KY LLC 5% Or Greater Direct Ownership Interest Nov 1, 2007 100%
Jjla LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2007 20%

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20070914000267 KY Part a Provider - Skilled Nursing Facility 8729172242 Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 100452 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

1120 Cristland Rd
Louisville, KY 40214-4150

Mailing address

12201 Bluegrass Pkwy
Louisville, KY 40299-2361
Phone (502) 568-7800

Other names 1

NPPES NPI Registry
  • Signature HealthCARE of South Louisville Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 4, 2023.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1891986170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800",
            "fax_number": "502-568-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 CRISTLAND RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402144150",
            "telephone_number": "502-367-0104",
            "fax_number": "502-368-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP LOUISVILLE SOUTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LP CR HOLDINGS LLC",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-568-7800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature HealthCARE of South Louisville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Signature HealthCARE of South Louisville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.