EXTENDICARE HOMES, INC. (NPI# 1043383771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043383771 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HOMES, INC. |
| Other Organization Name | MEDCO CENTER OF HENDERSON |
| Practice Address |
2500 N Elm St Henderson KY 42420-2005 |
| Mailing Address |
111 W Michigan St Milwaukee WI 53203-2903 |
| Practice Telephone | 2708269794 |
| Practice Fax Number | 2708266265 |
| Mailing Telephone | 4149088119 |
| Mailing Fax Number | 4149087105 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2008-04-01 |
| Authorized Official Name | DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE) |
| Authorized Official Telephone | 4149088119 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 12501920 | 05 |
| Other Name | Type Code |
|---|---|
| Medco Center of Henderson | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740345800 | Extendicare Homes, Inc. | Assisted Living Facility | 100 E Dalke Ave, Spokane, WA 99208-1006 | 2006-12-27 |
| 1639245558 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2006-11-24 |
| 1912070624 | Extendicare Homes, Inc. | Skilled Nursing Facility | 414 Robey St, Franklin, KY 42134-1034 | 2006-11-17 |
| 1790859486 | Extendicare Homes, Inc. | Skilled Nursing Facility | 3431 N 13th St, Sheboygan, WI 53083-2938 | 2006-11-17 |
| 1871666560 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1561 Newton Ave, Bowling Green, KY 42104-3238 | 2006-11-17 |
| 1215001862 | Extendicare Homes, Inc. | Skilled Nursing Facility | 619 W Walnut St, Milwaukee, WI 53212-3839 | 2006-11-17 |
| 1619041340 | Extendicare Homes, Inc. | Skilled Nursing Facility | 867 Mcguire Ave, Paducah, KY 42001-4036 | 2006-11-17 |
| 1255405700 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2582 Cerulean Rd, Cadiz, KY 42211-9605 | 2006-11-17 |
| 1376617837 | Extendicare Homes, Inc. | Skilled Nursing Facility | 420 E Grundy Ave, Springfield, KY 40069-1173 | 2006-11-17 |
| 1184798712 | Extendicare Homes, Inc. | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2006-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | EXTENDICARE HOMES, INC. | 3500 Lenox Road Ne, Suite 510, Atlanta, GA 30326 |
| Street Address |
2500 N ELM ST |
| City | HENDERSON |
| State | KY |
| Zip Code | 42420-2005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932684230 | Henderson Opco LLC | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 2018-10-02 |
| 1023378486 | Henderson Health Facilities Lp | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 2012-05-20 |
| 1154647204 | Misty Ann Rodriguez | Occupational Therapy Assistant | 2500 N Elm St, Henderson, KY 42420-2005 | 2010-04-14 |
| 1780900258 | Elizabeth Miller | Speech-Language Pathologist | 2500 N Elm St, Henderson, KY 42420-2005 | 2010-04-08 |
| 1437473600 | Tammy J Dallmeier | Physical Therapy Assistant | 2500 N Elm St, Henderson, KY 42420-2005 | 2010-03-17 |
| 1710201058 | Kristin T Okumura | Physical Therapist | 2500 N Elm St, Henderson, KY 42420-2005 | 2010-03-16 |
| 1053634576 | Kristin Jones | Occupational Therapy Assistant | 2500 N Elm St, Henderson, KY 42420-2005 | 2010-03-11 |
| 1588864318 | Sarah Marie Eastwood | Occupational Therapy Assistant | 2500 N Elm St, Henderson, KY 42420-2005 | 2007-07-19 |
| 1497952402 | Sabrina Dawn Holmes | Physical Therapy Assistant | 2500 N Elm St, Henderson, KY 42420-2005 | 2007-07-02 |
| 1841497104 | Christa Dawn Gilford | Occupational Therapy Assistant | 2500 N Elm St, Henderson, KY 42420-2005 | 2007-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174136337 | Virtual Consult Md LLC | Psychiatry & Neurology | 2202 Hwy 41 North, Unit E 152, Hendereson, KY 42420 | 2020-08-27 |
| 1679062731 | Maranda Wortham Miles | Nurse Practitioner | 2242 Hwy 41 North, Henderson, KY 42420 | 2018-05-04 |
| 1780124297 | Lisa Lovell | Nurse Practitioner | 230 North Green Street, Henderson, KY 42420 | 2017-03-02 |
| 1437540614 | Kala Hovermale | Social Worker | 220 2nd Street Ste 406, Henderson, KY 42420 | 2015-02-10 |
| 1972991537 | Jessica Thomas | Counselor | 230 Second St, Suite 406, Henderson, KY 42420 | 2015-01-06 |
| 1255690962 | Green River District Health Department | Public Health or Welfare | 631 N. Green Street, Henderson, KY 42420 | 2012-05-15 |
| 1588922769 | Jonathan M Mosley | Family Medicine | 1200 Barrett Blvd, Henderson, KY 42420 | 2012-04-25 |
| 1093099731 | Gregory Ayuk | Pharmacist | 402 Second Street, Henderson, KY 42420 | 2011-09-29 |
| 1437488137 | Peter J. Doll, D.p.m. | Durable Medical Equipment & Medical Supplies | 323 8th St., Henderson, KY 42420 | 2009-12-09 |
| 1760626402 | Linda Dalton Keith | Nurse Practitioner | 1704 2nd St, Henderson, KY 42420 | 2009-04-24 |
| Find all providers in zip 42420 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811421712 | Henderson Long Term Care LLC | Skilled Nursing Facility | 2965 Wigwam Parkway, Henderson, NV 89074 | 2017-04-18 |
| 1437697430 | Ahc of Henderson LLC | Skilled Nursing Facility | 1285 East Cactus Avenue, Henderson, NV 89183-7714 | 2017-02-09 |
| 1508303090 | Ghc of Henderson LLC | Skilled Nursing Facility | 2855 W Horizon Ridge Pkwy, Henderson, NV 89052 | 2017-01-23 |
| 1699111948 | Advancing Teams Management LLC | Skilled Nursing Facility | 712 Fair Park Dr, Henderson, TX 75654-3208 | 2013-05-14 |
| 1356402515 | Autumn Leaves Nursing and Rehab Inc | Skilled Nursing Facility | 321 Kilgore Dr, Henderson, TX 75652-5215 | 2006-12-12 |
| 1316034598 | Thi of Nevada At Henderson Convalescent LLC | Skilled Nursing Facility | 1180 E Lake Mead Pkwy, Henderson, NV 89015-5561 | 2006-10-07 |
| 1902997356 | Chester Co Healthcare, Inc. | Skilled Nursing Facility | 412 Juanita Dr, Henderson, TN 38340-1949 | 2006-09-28 |
| 1033220348 | Kindred Nursing Centers East, L.L.C. | Skilled Nursing Facility | 280 S Beckford Dr, Henderson, NC 27536-2564 | 2006-08-31 |
| 1972547321 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 1245 Park Ave, Henderson, NC 27536-4025 | 2006-06-16 |
| 1922065655 | Nexion Health At Southwood Inc | Skilled Nursing Facility | 701 Fair Park Dr, Henderson, TX 75654-3207 | 2006-04-27 |
| Find all providers in HENDERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.