EXTENDICARE, INC
NPI 1487669115
Skilled Nursing Facility in Dothan, AL

Active since July 30, 2006CLIA 01D0986805 · Waiver
950 S SAINT ANDREWS ST, DOTHAN, AL 36301(334) 793-1177(334) 699-3948 Get Directions Write a Review

NPPES record last updated: February 29, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Extendicare, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXTENDICARE, INC (NPI 1487669115) is a healthcare organization registered as a skilled nursing facility in Dothan, Alabama and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through May 22, 2027 and lists David Dennis, Ceo, as its authorized official.

NPPES Registry Identity

NPI1487669115
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameEXTENDICARE, INC
Location Address950 S SAINT ANDREWS STDothan, AL 36301-3684
Mailing AddressPmb 391, 104 Apple Ave Suite 3Dothan, AL 36303 · (334) 793-1177 · Fax (334) 699-3948
Fax(334) 699-3948
Organization SubpartNo
Authorized OfficialDavid DennisCeo · (334) 793-1177
Enumeration DateJuly 30, 2006
Last NPPES UpdateFebruary 29, 2024
NPPES CertifiedDecember 26, 2023
NPI 1487669115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in AL · N3501
Definition
(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.
950 S SAINT ANDREWS ST, Dothan, AL 36301

Other Identifiers 1

Medicaid4757020SAL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 01D0986805

Noland Extendicare, LLC Dba Extendicare Health And Rehab · Dothan, AL
Active · expires May 22, 2027
CLIA Number01D0986805
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateMay 23, 2025
Certificate Expiration DateMay 22, 2027
Laboratory DirectorAnita Kay Cobb Rn
Laboratory Phone(334) 793-1177
Laboratory LocationNoland Extendicare, LLC Dba Extendicare Health And Rehab950 S Saint Andrews Street, Dothan, AL 36301
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
950 S SAINT ANDREWS ST
DOTHAN, AL 36301
Skilled Nursing Facility
950 S SAINT ANDREWS ST
DOTHAN, AL 36301
Registered Nurse (Gerontology)
950 S SAINT ANDREWS ST
DOTHAN, AL 36301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Extendicare, Inc's NPI number?

The NPI number for Extendicare, Inc is 1487669115. It was assigned to this organization in the NPPES registry on July 30, 2006.

Where is Extendicare, Inc located?

Extendicare, Inc is located at 950 S Saint Andrews St, Dothan, AL 36301. The listed phone number is (334) 793-1177.

What is Extendicare, Inc's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Extendicare, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D0986805) is associated with this NPI, valid through May 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Extendicare, Inc was last updated on February 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.