Manor Care-Roland Park MD LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

30-013 Issued in MD

Legal business name

MANOR CARE-ROLAND PARK MD LLC

Doing business as

ProMedica Skilled Nursing and Rehabilitation (Roland Park)

Practice address

4669 Falls Rd
Baltimore, MD 21209-4914

Phone

(410) 662-8606

Fax

(410) 662-8608

NPI assigned

May 28, 2006

Last updated

Jan 25, 2022By 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

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Roland Park) Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1952358566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4669 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094914",
            "telephone_number": "410-662-8606",
            "fax_number": "410-662-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE-ROLAND PARK MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "30-013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413521100",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Roland Park)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ivy Mannoh
• Heather D Mannuel, MD
• Vinesh Manohar, M.D
• Amir Manoochehri
• Sofia Manoogian
• Manor Care-Rossville MD LLC (ProMedica Skilled Nursing and Rehabilitation (Rossville))
• Lindsey Lee Manos, DHSC, PA-C
• Lauren Morgan Manrai, CRNP-AC
• Yulonda Mansaray
• Richard Manski, D.D.S.

• Skilled Nursing Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.