EXTENDICARE HOMES, INC. (NPI# 1336212034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336212034 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HOMES, INC. |
| Other Organization Name | MEDCO CENTER OF BRANDENBURG |
| Practice Address |
814 Old Ekron Rd Brandenburg KY 40108-1149 |
| Mailing Address |
111 W Michigan St Milwaukee WI 53203-2903 |
| Practice Telephone | 2704222148 |
| Practice Fax Number | 2704224791 |
| 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 | 12501698 | 05 |
| Other Name | Type Code |
|---|---|
| Medco Center of Brandenburg | 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 |
| 1043383771 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | EXTENDICARE HOMES, INC. | 3500 Lenox Road Ne, Suite 510, Atlanta, GA 30326 |
| Street Address |
814 OLD EKRON RD |
| City | BRANDENBURG |
| State | KY |
| Zip Code | 40108-1149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467937748 | Brandenburg Opco LLC | Skilled Nursing Facility | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2018-10-02 |
| 1942560305 | Brandenburg Health Facilities Lp | Skilled Nursing Facility | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2012-05-20 |
| 1891992905 | Kathleen Nicole Terry | Physical Therapy Assistant | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2007-07-02 |
| 1619174729 | Derek Thomas Edlin | Occupational Therapy Assistant | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2007-07-02 |
| 1255538351 | Calandra Stark Edlin | Occupational Therapist | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2007-07-02 |
| 1750588000 | Lisa G Tindell | Speech-Language Pathologist | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2007-06-29 |
| 1609073980 | Dana Carol Buren | Occupational Therapist | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2007-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316468036 | Elisabeth Shoulders | Specialist/Technologist | 1010 Turner Road, Brandenburg, KY 40108 | 2017-07-03 |
| 1760890958 | Kimberly Ryan | Social Worker | 2020 Bypass Rd, Brandenburg, KY 40108 | 2014-07-31 |
| 1962790600 | Meade Family Eye, Pllc | Optometrist | 664 By Pass Rd, Brandenburg, KY 40108 | 2011-07-15 |
| 1295066934 | Raymond Lewis Mathis | Family Medicine | 65 Cedar Vista Dr, Brandenburg, KY 40108 | 2010-01-20 |
| 1790951804 | Elizabeth Mary Wright | Physical Therapist | 1155 Old Ekron Rd, Brandenburg, KY 40108 | 2008-05-08 |
| 1427240704 | Bluegrass Massage Theraputics | Clinic/Center | 365 East Broadway Suite 2, Brandenburg, KY 40108 | 2007-08-10 |
| 1710969316 | Lincoln Trail District Health Dept | Public Health or Welfare | 520 Hillcrest Dr, Brandenburg, KY 40108 | 2005-11-18 |
| 1437676475 | Ack Healthcare Management, LLC | Nurse Practitioner | 2025 Bypass Rd Ste 205, Brandenburg, KY 40108 | 2017-08-29 |
| 1598135055 | Forefront Dermatology, S.c. | Dermatology | 100 Commerce Dr, C/o Brandenburg Diagnostic Center, Brandenburg, KY 40108 | 2015-09-28 |
| 1457479396 | Robert Eugene Smith | Family Medicine | 534 Hillcrest Drive, Brandenburg, KY 40108 | 2007-03-27 |
| Find all providers in zip 40108 | ||||
| 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 |
|---|---|---|---|---|
| 1467937748 | Brandenburg Opco LLC | Skilled Nursing Facility | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2018-10-02 |
| 1942560305 | Brandenburg Health Facilities Lp | Skilled Nursing Facility | 814 Old Ekron Rd, Brandenburg, KY 40108-1149 | 2012-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163697 | Providence Point Healthcare, Inc. | Skilled Nursing Facility | 100 Marshall Ct, Paducah, KY 42001-9639 | 2020-10-28 |
| 1366062432 | Exceptional Senior Living-prospect, LLC | Skilled Nursing Facility | 6901 Carslaw Ct, Prospect, KY 40059-8358 | 2020-04-20 |
| 1811527617 | Trilogy Healthcare of Bullitt, LLC | Skilled Nursing Facility | 119 East Sanders Lane, Mt. Washington, KY 40047 | 2020-01-21 |
| 1659856961 | Salyersville Health Operating Company LLC | Skilled Nursing Facility | 662 Parkway Dr, Salyersville, KY 41465-9249 | 2018-10-02 |
| 1104307271 | Boonespring Transitional Care Center, LLC | Skilled Nursing Facility | 10250 Us 42, Union, KY 41091 | 2018-08-27 |
| 1740710623 | Landmark of Louisville Rehabilitation and Nursing Center | Skilled Nursing Facility | 1155 Eastern Parkway, Louisville, KY 40217 | 2017-06-14 |
| 1437682309 | Landmark of Lancaster Rehabilitation and Nursing Center | Skilled Nursing Facility | 308 W Maple Ave, Lancaster, KY 40444-1005 | 2017-04-07 |
| 1962954529 | Martin Manor Operations, LLC | Skilled Nursing Facility | 62 Maude Rd., Inez, KY 41224 | 2016-10-31 |
| 1023560661 | Robertson Operations, LLC | Skilled Nursing Facility | Route 2 Hwy 62, Mt. Olivet, KY 41064 | 2016-10-31 |
| 1205386208 | Vanceburg Leasing, LLC | Skilled Nursing Facility | 58 Eastham St, Vanceburg, KY 41179-5462 | 2016-10-13 |
| Find all providers with the same taxonomy | ||||
| City | BRANDENBURG |
| Zip Code | 40108 |
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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.