Vanguard of Manchester, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0000000355 Issued in TN

Legal business name

VANGUARD OF MANCHESTER, LLC

Doing business as

Manchester Health Care Center

Practice address

395 Interstate Dr
Manchester, TN 37355

Phone

(931) 723-8744

Fax

(931) 723-8738

NPI assigned

Jan 13, 2006

Last updated

May 24, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

VANGUARD HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Mr. John T Fick

Title

Secretary

Phone

(615) 250-7100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Manchester Health Care Center Doing business as

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1992784326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 OVERLOOK BLVD STE 202",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272755",
            "telephone_number": "615-250-7100",
            "fax_number": "615-250-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 INTERSTATE DR",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "37355",
            "telephone_number": "931-723-8744",
            "fax_number": "931-723-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD OF MANCHESTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VANGUARD HEALTHCARE, LLC",
        "enumeration_date": "2006-01-13",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "FICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-250-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445391",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440587",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manchester Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Manchester Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.