Dover Manor, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100480 Issued in KY

Legal business name

DOVER MANOR, INC.

Practice address

112 Dover Dr
Georgetown, KY 40324-9741

Phone

(502) 863-9529

NPI assigned

May 23, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah J McIntosh

Title

Assistant Controller

Phone

(270) 338-2401

Specialties & licenses 2

Addresses

Other identifiers 4

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1922001148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 529",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423450529",
            "telephone_number": "270-338-2401",
            "fax_number": "270-338-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 DOVER DR",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249741",
            "telephone_number": "502-863-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVER MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASSISTANT CONTROLLER",
        "authorized_official_telephone_number": "270-338-2401",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100480",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "90003377",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS PART B",
            "identifier": "000000316058",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90003377",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000271318",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12501755",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyndsay Dixon
• Theodosia Vittos Dodson, M.S., CF-SLP
• Heather Nicole Dombrowsky, MA
• Jamie Doty, LPCC
• Dover Manor Operations LLC
• Kevin Downes, M.D.
• Drayer Physical Therapy Institute of Kentucky PLLC (Kentucky Hand - Georgetown)
• Drayer Physical Therapy Kentucky LLC (Kentucky Hand - Georgetown)
• Serge Dubuc, M.D.
• Hannah Dumais

• Skilled Nursing Facility in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Skilled Nursing Facility in Kentucky

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