CALVERT CITY CONVALESCENT CENTER, INC (NPI# 1588650618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588650618 |
| Entity Type | Organization |
| Organization Name | CALVERT CITY CONVALESCENT CENTER, INC |
| Practice Address |
1201 5th Ave Calvert City KY 42029-8233 |
| Mailing Address |
1201 5th Ave Po Box 7 Calvert City KY 42029-8233 |
| Practice Telephone | 2703954124 |
| Practice Fax Number | 2703954962 |
| Mailing Telephone | 2703954124 |
| Mailing Fax Number | 2703954962 |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. LAURIE M TRAVIS (ASST BUSINESS ADMN) |
| Authorized Official Telephone | 2703954124 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 12500443 | 05 |
| Street Address |
1201 5TH AVE |
| City | CALVERT CITY |
| State | KY |
| Zip Code | 42029-8233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013028984 | Laura Catherine Harrison | Physical Therapist | 1201 5th Ave, Calvert City, KY 42029-8233 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619497179 | Sunetta Barrett | Registered Nurse | 563 East 5th Ave, Calvert City, KY 42029 | 2017-06-26 |
| 1649790882 | Cynthia Jill Landon | Registered Nurse | 3110 Hwy 95, Calvert City, KY 42029 | 2017-06-20 |
| 1285018564 | Jason Doughty | Physical Therapy Assistant | 186 Breeze Lane, Calvert City, KY 42029 | 2015-07-16 |
| 1104127125 | Gary Webster Smith | Dentist | 404 Fifth Ave., Calvert City, KY 42029 | 2010-11-08 |
| 1750694972 | Marshall County Health Department | Public Health or Welfare | 503 A 5th Ave S.e., Calvert City, KY 42029 | 2010-07-16 |
| 1578727491 | Jenny Sanderson Story | Speech-Language Pathologist | 110 Convalescent Dr, Calvert City, KY 42029 | 2008-07-10 |
| 1285897678 | Michele Christine Stariwat | Occupational Therapy Assistant | 110 Convalescent Drive, Calvert City, KY 42029 | 2008-07-07 |
| 1194986984 | Scott C Stephenson | Chiropractor | 1665 Oak Park Boulevard, Suite A, Calvert City, KY 42029 | 2008-06-24 |
| 1477735694 | John P Lyles Optometrist | Optometrist | 43 Industrial Parkway, Calvert City, KY 42029 | 2007-11-29 |
| 1528254299 | Andrea Norenne Jennings | Massage Therapist | 5119 U.S. Highway 62, Calvert City, KY 42029 | 2007-09-17 |
| Find all providers in zip 42029 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093945511 | Center for Comprehensive Services, Inc | Nursing Facility/Intermediate Care Facility | 148 Stuart Nelson Park Rd, Paducah, KY 42001-9678 | 2009-07-17 |
| 1548402720 | Christian Care Center of Kuttawa, LLC | Nursing Facility/Intermediate Care Facility | 1253 Lake Barkley Drive, Kuttawa, KY 42055-6124 | 2009-04-02 |
| 1912172768 | United Methodist Retirement Community, Inc. | Nursing Facility/Intermediate Care Facility | 1125 Lexington Rd, Wilmore, KY 40390-9641 | 2008-04-23 |
| 1891979886 | Total Long-term Care Solutions, Pllc | Nursing Facility/Intermediate Care Facility | 3623 E Locust Cir, Prospect, KY 40059-9020 | 2007-12-26 |
| 1649484015 | Village of Lebanon II, LLC | Nursing Facility/Intermediate Care Facility | 105 Village Way, Lebanon, KY 40033-1845 | 2007-05-09 |
| 1396962551 | Commonwealth of Kentucky | Nursing Facility/Intermediate Care Facility | 200 Veterans Dr, Hazard, KY 41701-9484 | 2007-04-19 |
| 1437373636 | Advanced Living, Inc. | Nursing Facility/Intermediate Care Facility | 2121 Argillite Rd, Flatwoods, KY 41139-2615 | 2007-04-12 |
| 1346361193 | Letcher County Golden Years Rest Home | Nursing Facility/Intermediate Care Facility | 53 Wheaton Hollow Road, Jenkins, KY 41537 | 2007-04-02 |
| 1639241433 | Hicks Enterprises of Monticello, LLC | Nursing Facility/Intermediate Care Facility | 1801 W. Hwy. 90 By-pass, Monticello, KY 42633 | 2006-11-15 |
| 1700960820 | Mckenzie Health Care, LLC | Nursing Facility/Intermediate Care Facility | 270 E Clayton Ln, Louisa, KY 41230-8622 | 2006-10-25 |
| Find all providers with the same taxonomy | ||||
| City | CALVERT CITY |
| Zip Code | 42029 |
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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.