EXTENDICARE HEALTH SERVICES (NPI# 1083002521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083002521 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HEALTH SERVICES |
| Practice Address |
712 W 2nd St Leavenworth IN 47137-2264 |
| Practice Telephone | 8127392292 |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2015-01-07 |
| Authorized Official Name | MR. MICHAEL MATTHEWS (PTA) |
| Authorized Official Telephone | 8127392292 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 06004780A | IN | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | EXTENDICARE HEALTH SERVICES, INC. | 111 W Michigan St, Milwaukee, WI 53203 |
| Washington State Corporations | EXTENDICARE HEALTH SERVICES, INC. | 111 W Michigan St, Milwaukee, WI 53203 |
| Street Address |
712 W 2ND ST |
| City | LEAVENWORTH |
| State | IN |
| Zip Code | 47137-2264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851789499 | Erica Pulce-perry | Physical Therapist | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2015-01-06 |
| 1457756256 | Julie Hillenbrand Sellner | Occupational Therapy Assistant | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2014-10-23 |
| 1285038190 | Samantha Jane Mccollom | Occupational Therapy Assistant | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2014-10-21 |
| 1205278397 | Abigail Preher | Occupational Therapist | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2013-07-18 |
| 1164778981 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 712 W 2nd St, Leavenworth, IN 47137 | 2012-07-30 |
| 1952685596 | Kasie D Reed | Physical Therapy Assistant | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2011-09-30 |
| 1568746105 | Jill Fleace | Occupational Therapy Assistant | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2011-09-30 |
| 1932483575 | Arthur Klint Kaiser | Physical Therapy Assistant | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2011-09-30 |
| 1871824631 | Jenna Leigh Lillpop | Physical Therapist | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2010-01-19 |
| 1679804546 | Stephanie Marie Trowbridge | Physical Therapy Assistant | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2010-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730293978 | Kristina S. Gunter | Physician Assistant | 368 West Old Hwy 62, Leavenworth, IN 47137 | 2006-08-17 |
| 1710093091 | Harrison County Hospital | Internal Medicine | 368 W Old State Road 62, Leavenworth, IN 47137-2290 | 2006-08-21 |
| 1891099644 | Elizabeth Claire Mcmillan | Speech-Language Pathologist | 4280 E Mansfield Rd, Leavenworth, IN 47137-8210 | 2011-01-07 |
| 1588136618 | Patricia Jo Kane | Developmental Therapist | 8147 S State Road 66, Leavenworth, IN 47137-8314 | 2018-12-31 |
| 1972877280 | Little Company of Mary Hospital of Indiana Inc | Family Medicine | 6402 E Industrial Lane, Leavenworth, IN 47137-8316 | 2012-03-05 |
| 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 |
|---|---|---|---|---|
| 1972994036 | Sisters of Charity of Leavenworth | Skilled Nursing Facility | 4200 S 4th St, Leavenworth, KS 66048-5054 | 2015-02-11 |
| 1164778981 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 712 W 2nd St, Leavenworth, IN 47137 | 2012-07-30 |
| 1083786776 | Indiana Health and Rehabilitation Centers | Skilled Nursing Facility | 712 W 2nd St, Leavenworth, IN 47137-2264 | 2006-11-15 |
| 1942300215 | Medicalodges, Inc. | Skilled Nursing Facility | 1503 Ohio St, Leavenworth, KS 66048-2932 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618956 | Empowerme Rehabilitation Illinois, LLC | Skilled Nursing Facility | 3203 E Moores Pike, Bloomington, IN 47401-7122 | 2020-10-29 |
| 1629698808 | Decatur County Memorial Hospital | Skilled Nursing Facility | 6712 Restoracy Drive, Whitestown, IN 46075-0089 | 2020-04-17 |
| 1922586510 | Aperion Care Marion LLC | Skilled Nursing Facility | 614 W 14th St, Marion, IN 46953-2158 | 2018-08-06 |
| 1427548270 | Vibra Rehabilitation Hospital of Southern Indiana, LLC | Skilled Nursing Facility | 3104 Blackiston Boulevard, New Albany, IN 47150-9579 | 2018-05-17 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1366974404 | Mika Riddle | Skilled Nursing Facility | 407 W Walnut St, Van Buren, IN 46991 | 2017-03-29 |
| 1245787076 | Sara Steffe | Skilled Nursing Facility | 1015 Virginia St, Ferdinand, IN 47532-9285 | 2016-09-09 |
| 1770030504 | Valerie Burdette | Skilled Nursing Facility | 1872 E County Road 825 S, Oakland City, IN 47660-8911 | 2016-09-09 |
| 1205286507 | Christina Basham | Skilled Nursing Facility | 710 Bluffview Dr, Angola, IN 46703-2206 | 2016-06-16 |
| 1164878583 | Good Samaritan Hospital | Skilled Nursing Facility | 811 E. Baseline Road, Evansville, IN 47725-9340 | 2016-05-05 |
| Find all providers with the same taxonomy | ||||
| City | LEAVENWORTH |
| Zip Code | 47137 |
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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.