Colonial Terrace Intermediate Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100440 Issued in KY

Legal business name

COLONIAL TERRACE INTERMEDIATE CARE, INC.

Practice address

142 Roger Powell Rd
Sebree, KY 42455-2115

Phone

(270) 835-2533

Fax

(270) 853-9004

NPI assigned

Sep 16, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Terry Lynn Skaggs

Title

Cfo

Phone

(270) 926-9355

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1992790802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 HARVARD DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423016185",
            "telephone_number": "270-926-9355",
            "fax_number": "270-684-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 ROGER POWELL RD",
            "city": "SEBREE",
            "state": "KY",
            "postal_code": "424552115",
            "telephone_number": "270-835-2533",
            "fax_number": "270-853-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL TERRACE INTERMEDIATE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "SKAGGS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "270-926-9355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "100440",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "KY",
            "license": "100440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12501789",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bells Drugs Inc
• Robin Turner Brown, COTA/L
• Crystal Cheri Buchanan, APRN
• Holly Michelle Cardwell, APRN
• Deaconess Clinic, Inc
• Goben Family Care
• Joy Goben, APRN
• Green River District Health Department
• Brenda Terry Hamela, O.T.R.

• All providers in Sebree, KY
• Skilled Nursing Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.