DIVERSICARE OF GREENVILLE, LLC (NPI# 1184024424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184024424 |
| Entity Type | Organization |
| Organization Name | DIVERSICARE OF GREENVILLE, LLC |
| Other Organization Name | DIVERSICARE OF GREENVILLE |
| Practice Address |
521 Greene Dr Greenville KY 42345-1409 |
| Practice Telephone | 2703381523 |
| Practice Fax Number | 6156207875 |
| Mailing Telephone | 2703381523 |
| Mailing Fax Number | 6156207875 |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2015-10-21 |
| Authorized Official Name | KELLY J GILL (PRESIDENT AND CEO) |
| Authorized Official Telephone | 6157717575 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIVERSICARE LEASING COMPANY II, LLC |
| 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 | 7100364170 | 05 |
| Other Name | Type Code |
|---|---|
| Diversicare of Greenville | Doing Business As Name - Organization |
| Street Address |
521 GREENE DR |
| City | GREENVILLE |
| State | KY |
| Zip Code | 42345-1409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023029428 | Central City Enterprises Inc. | Nursing Facility/Intermediate Care Facility | 521 Greene Dr, Greenville, KY 42345-1409 | 2006-08-10 |
| 1780216721 | Jamie Durham | Nurse Practitioner | 521 Greene Dr, Greenville, KY 42345-1409 | 2020-02-07 |
| 1407401375 | Greenville Nursing and Rehabilitation LLC | Skilled Nursing Facility | 521 Greene Dr, Greenville, KY 42345-1409 | 2019-08-07 |
| 1669839247 | Leslie Handley | Speech-Language Pathologist | 521 Greene Dr, Greenville, KY 42345-1409 | 2016-01-27 |
| 1700243839 | Amy Nelson | Occupational Therapist | 521 Greene Dr, Greenville, KY 42345-1409 | 2016-01-20 |
| 1699132712 | Elizabeth A Story | Speech-Language Pathologist | 521 Greene Dr, Greenville, KY 42345-1409 | 2016-01-20 |
| 1972514206 | Royal Manor, Inc. | Nursing Facility/Intermediate Care Facility | 521 Greene Dr, Greenville, KY 42345-1409 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669607917 | Felicia Wells | Speech-Language Pathologist | 515 Greene Drive, Greenville, KY 42345 | 2009-05-15 |
| 1992968085 | Roberta A Shelton | Occupational Therapist | 515 Green Drive, Greenville, KY 42345 | 2008-07-08 |
| 1659547503 | Kellyn Jones | Counselor | 506 W. Hopkinsville St, Greenville, KY 42345 | 2008-05-01 |
| 1922134956 | Guinn Shaw Cost Jr. | Family Medicine | 132 Sara's Lane, Greenville, KY 42345 | 2007-02-26 |
| 1205883949 | Katharine S Cox | Emergency Medicine | 504 Hopkinsville St, Greenville, KY 42345 | 2006-05-28 |
| 1265922447 | George Michael Garrett | Nurse Practitioner | 440 Hopkinsville St, Greenville, KY 42345 | 2018-05-14 |
| 1376088930 | Community Health Centers of Western Kentucky Inc | Social Worker | 226 Hopkinsville St, Greenville, KY 42345 | 2017-01-05 |
| 1982009585 | Kentucky Emergency I Services Psc | Physician Assistant | 440 Hopkinsville St, Greenville, KY 42345 | 2014-10-27 |
| 1538447016 | Christina N Buckley | Nurse Practitioner | 440 Hopkinsville St, Greenville, KY 42345 | 2011-08-01 |
| 1245542331 | James Derek Calhoun | Nurse Practitioner | 440 Hopkinsville St, Greenville, KY 42345 | 2010-07-06 |
| Find all providers in zip 42345 | ||||
| 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 |
|---|---|---|---|---|
| 1437673456 | 13455 Golden LLC | Skilled Nursing Facility | 13455 West Highway 90, Greenville, FL 32331 | 2017-08-01 |
| 1710348305 | Maybrook-c Whitecliff Opco LLC | Skilled Nursing Facility | 110 Fredonia Road, Greenville, PA 16125-7911 | 2016-03-10 |
| 1154792000 | East Carolina Rehab and Wellness, LLC | Skilled Nursing Facility | 2575 W 5th St, Greenville, NC 27834-7813 | 2015-10-16 |
| 1972932879 | Crosswinds Rehab | Skilled Nursing Facility | 13455 W Us Hwy 90, Greenville, FL 32331 | 2013-11-01 |
| 1427484195 | Greenville Nursing and Rehabilitation, LLC | Skilled Nursing Facility | 117 Sycamore Street, Greenville, MO 63944-0108 | 2013-09-25 |
| 1255778064 | Providence Home Care LLC | Skilled Nursing Facility | 128 Millport Cir, Suite 200, Greenville, SC 29607-5571 | 2013-06-03 |
| 1548572894 | Patewood Rehabilitation and Healthcare Center, LLC | Skilled Nursing Facility | 2 Griffith Rd., Greenville, SC 29607-3503 | 2010-07-01 |
| 1952530867 | Upstate Senior Living, Inc. | Skilled Nursing Facility | 50 Arboretum Way, Greenville, SC 29617-6226 | 2009-07-13 |
| 1225276736 | 13455 Management LLC | Skilled Nursing Facility | 13455 West Us Highway 90, Greenville, FL 32331 | 2009-01-22 |
| 1285879437 | Benchmark Healthcare of Greenville, LLC | Skilled Nursing Facility | 108 Sycamore St, Greenville, MO 63944-0108 | 2008-12-02 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 42345 |
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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.