Kindred Nursing Centers West, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

25 Issued in ID

Legal business name

KINDRED NURSING CENTERS WEST, LLC

Doing business as

Kindred Nursing and Rehabilitation-Canyon West

Practice address

2814 S Indiana Ave
Caldwell, ID 83605-5925

Phone

(208) 459-0808

Fax

(208) 459-2876

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Marilyn A Weaver

Title

Assistant Secretary

Phone

(502) 596-7563

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kindred Nursing and Rehabilitation-Canyon West Doing business as

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1902810492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S. 4TH STREET",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-7301",
            "fax_number": "502-596-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 S INDIANA AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055925",
            "telephone_number": "208-459-0808",
            "fax_number": "208-459-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED NURSING CENTERS WEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7563",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ID",
            "license": "25",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805220700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Nursing and Rehabilitation-Canyon West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Keylor, LMSW
• Leila Khaddour, MD
• Kimberly Drewrey, Aprn, NP-C
• L. Mark Kimsey, M.D.
• Kindred Nursing Centers West, LLC
• Dawson King
• Robin King, D.C.
• Kirby Clendenon DDS
• Rikki Koberlein, RN
• Steven J Koga, M.D.

• Skilled Nursing Facility in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Skilled Nursing Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; 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.