PINE TREE VILLA, LLC (NPI# 1114030624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114030624 |
| Entity Type | Organization |
| Organization Name | PINE TREE VILLA, LLC |
| Other Organization Name | REGIS WOODS |
| Practice Address |
4604 Lowe Rd Louisville KY 40220-1514 |
| Mailing Address |
101 Sun Ave Ne Compliance Department Albuquerque NM 87109-4373 |
| Practice Telephone | 5024511401 |
| Practice Fax Number | 5024851999 |
| Mailing Telephone | 5054685604 |
| Mailing Fax Number | 5054684681 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2016-08-19 |
| Authorized Official Name | MICHAEL T BERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 5054684742 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUNBRIDGE HEALTHCARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 100503 | KY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 12504882 | 05 |
| Other Name | Type Code |
|---|---|
| Regis Woods | Doing Business As Name - Organization |
| Street Address |
4604 LOWE RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40220-1514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336185354 | Tami Secor | Internal Medicine | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2006-06-20 |
| 1316442643 | Elisa Marie Freeman | Physical Medicine & Rehabilitation | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2018-03-28 |
| 1538671706 | Bethany Woodard | Physical Therapy Assistant | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2017-10-27 |
| 1881104172 | Brittney Skidmore | Speech-Language Pathologist | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2017-10-02 |
| 1295250256 | Adam Klein | Occupational Therapy Assistant | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2017-08-10 |
| 1588197271 | Aruna Mathew | Nurse Practitioner | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2017-04-10 |
| 1033503313 | Jessica White | Occupational Therapy Assistant | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2015-03-24 |
| 1770914087 | Allison Meehan | Physical Therapy Assistant | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2013-12-12 |
| 1932542354 | Virginia Marice Gallahue | Physical Therapy Assistant | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2013-04-16 |
| 1417293697 | Brittany Vetter | Speech-Language Pathologist | 4604 Lowe Rd, Louisville, KY 40220-1514 | 2012-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502560 | Louis James Walker IIi | Physical Therapist | 8904 Elks Bluff Drive, Unit 02206, Apt 206, Louisville, KY 40220 | 2020-09-10 |
| 1396207148 | Kristan Shay Swindler | Specialist/Technologist, Other | 3008 Furman Blvd., Louisville, KY 40220 | 2019-04-02 |
| 1033686191 | Reine Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3405 Breckenridge Lane, Louisville, KY 40220 | 2018-10-26 |
| 1053828145 | Angelique Marie Leist | Registered Nurse | 3103 Breckenridge Ln Ste 1, Louisville, KY 40220 | 2018-01-10 |
| 1811413925 | Virginia Zimlich | Physical Therapist | 2807 Alice Ave, Louisville, KY 40220 | 2017-08-21 |
| 1255860649 | Susan Marie Elder | Registered Nurse | 2816 Esther Blvd, Louisville, KY 40220 | 2017-06-08 |
| 1215300611 | Katie Kipfer | Day Training/Habilitation Specialist | 3902 Graf Drive, Louisville, KY 40220 | 2015-11-06 |
| 1639547987 | Meghan Hillerich | Home Health | 13 Canterbury Drive, Louisville, KY 40220 | 2015-09-03 |
| 1376921098 | Dental Services of Kentucky, Psc | Dentist | 3946 Taylorsville Rd., Louisville, KY 40220 | 2015-05-14 |
| 1093103574 | Joann Bartolone Murphy | Developmental Therapist | 3717 Taylorsville Rd., Louisville, KY 40220 | 2015-01-06 |
| Find all providers in zip 40220 | ||||
| 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 |
|---|---|---|---|---|
| 1255980876 | Ehcs Oakhill Properties, LLC | Skilled Nursing Facility | 4466 Lynnhaven Ave, Louisville, OH 44641-9513 | 2019-09-06 |
| 1740710623 | Landmark of Louisville Rehabilitation and Nursing Center | Skilled Nursing Facility | 1155 Eastern Parkway, Louisville, KY 40217 | 2017-06-14 |
| 1225405475 | Blount County Snf Operations, LLC | Skilled Nursing Facility | 1965 Stewart Lane, Louisville, TN 37777 | 2015-08-24 |
| 1952788408 | Bridgett Powers Mattingly | Skilled Nursing Facility | 117 Weisser Ave, Louisville, KY 40206-2761 | 2015-05-05 |
| 1235527300 | Trilogy Healthcare of Louisville Northeast, LLC | Skilled Nursing Facility | 4120 Wooded Acre Ln, Louisville, KY 40245-2938 | 2014-12-24 |
| 1215330345 | Jonathan Kratzwald | Skilled Nursing Facility | 8206 Happiness Way, Louisville, KY 40291-2865 | 2014-10-03 |
| 1043659626 | Niraj Mathur | Skilled Nursing Facility | 4209 Bridlepath Pl, Louisville, KY 40245-1971 | 2013-06-18 |
| 1235574161 | Balfour Retirement Community of Boulder County | Skilled Nursing Facility | 1855 Plaza Dr., Louisville, CO 80027 | 2013-05-06 |
| 1164703955 | Christian Health Center - West, Inc. | Skilled Nursing Facility | 1015 Magazine St, Louisville, KY 40203-2017 | 2011-09-07 |
| 1801193560 | Trilogy Healthcare of Louisville East, LLC | Skilled Nursing Facility | 4247 Westport Rd, Louisville, KY 40207-2227 | 2011-02-16 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40220 |
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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.