TRAYLOR NURSING HOME, INC (PHOENIX HEALTHCARE LLC) NPI 1366493066

Skilled Nursing Facility in Roanoke, AL

NPI 1366493066 Organization Skilled Nursing Facility

About TRAYLOR NURSING HOME, INC (PHOENIX HEALTHCARE LLC)

Traylor Nursing Home, Inc (phoenix Healthcare Llc) is a provider established in Roanoke, Alabama specializing in skilled nursing facility. The NPI number of Traylor Nursing Home, Inc (phoenix Healthcare Llc) is 1366493066 and was assigned on May 2006. The practitioner's primary taxonomy code is 314000000X with license number 10641 (AL). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Traylor Nursing Home, Inc. The authorized official of this NPI record is Mr. Ronald Traylor (Administrator)

NPI

1366493066

Provider NameTRAYLOR NURSING HOME, INC (PHOENIX HEALTHCARE LLC)
Provider Location Address1235 YANCEY ST ROANOKE, AL 36274
Provider Mailing AddressPO BOX 467 1235 YANCEY STREET ROANOKE, AL 36274
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameTRAYLOR NURSING HOME, INC
Other Name TypeDoing Business As (3)
Enumeration Date05-15-2006
Last Update Date12-20-2011


Primary Taxonomy

Taxonomy Code314000000X
ClassificationSkilled Nursing Facility
TypeNursing & Custodial Care Facilities
License No.10641
License StateAL
Taxonomy Description(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.

Business Address

TRAYLOR NURSING HOME, INC
1235 YANCEY ST
ROANOKE, AL
ZIP 36274
Phone: (334) 863-3500
Fax: (334) 863-3531

Get Directions


Mailing Address

TRAYLOR NURSING HOME, INC
PO BOX 467
1235 YANCEY STREET
ROANOKE, AL
ZIP 36274
Phone: (334) 863-3500
Fax: (334) 863-3531



Authorized Official

Authorized Official NameMR. RONALD TRAYLOR
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(334) 863-3500

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
021561OTHER (01)AL
015126MEDICARE OSCAR/CERTIFICATION (06)AL
1085810001MEDICARE NSC (07)AL
4752240SMEDICAID (05)AL

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1184182933 KARLY ANNE LINDROTH-YATES
Individual
Physical Therapist1235 YANCEY ST
ROANOKE, AL 36274
(334) 863-3535
1275947814 SHANNON FULLER RPT
Individual
Physical Therapist1235 YANCEY ST
ROANOKE, AL 36274
(334) 863-3535
1598159501RANDOLPH MANAGEMENT COMPANY, INC.
Organization
Skilled Nursing Facility1235 YANCEY ST
ROANOKE, AL 36274
(334) 863-3500

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.