SHREVEPORT MANOR, LLC
NPI 1417999780
Skilled Nursing Facility in Shreveport, LA

NPI Status: Active since June 12, 2006

Contact Information

3302 MANSFIELD RD
SHREVEPORT, LA
ZIP 71103
Phone: (318) 222-9482
Fax: (318) 424-9985

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  • Organization
  • Skilled Nursing Facility

About SHREVEPORT MANOR, LLC

This page provides the complete NPI Profile along with additional information for Shreveport Manor, Llc, a provider established in Shreveport, Louisiana operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1417999780 assigned on June 2006. The practitioner's primary taxonomy code is 314000000X with license number 866 (LA). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Mr. Kevin C Gamble (Officer)

NPI
1417999780
Provider Name
SHREVEPORT MANOR, LLC
Entity Type
Organization
Location Address
3302 MANSFIELD RD SHREVEPORT, LA 71103
Location Phone
(318) 222-9482
Location Fax
(318) 424-9985
Mailing Address
PO BOX 52389 SHREVEPORT, LA 71135
Mailing Phone
(318) 798-2648
Mailing Fax
(318) 424-9985
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-12-2006
Last Update Date
08-27-2010
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
866
License State
LA
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. KEVIN C GAMBLE

Authorized Official Title
OFFICER
Authorized Official Phone
(318) 798-2648

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1517569MEDICAID (05)LA 
195515MEDICARE ID-TYPE UNSPECIFIED (04)LAPROVIDER NUMBER

Reviews for SHREVEPORT MANOR, LLC

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1417999780
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
242718918716
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 2 + 7 + 1 + 8 + 9 + 1 + 8 + 7 + 1 + 6 + 24 = 80
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1417999780 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


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

NPI Name / Type Taxonomy Address
1376004796PMG OPCO-SHREVEPORT LLC
Organization
Skilled Nursing Facility3302 MANSFIELD RD
SHREVEPORT, LA 71103
(318) 222-9482
1942847454 TIFFANY LEFALL NP
Individual
Nurse Practitioner (Family)3302 MANSFIELD RD
SHREVEPORT, LA 71103
(337) 991-9276
1609257450SHREVEPORT SCC LLC
Organization
Skilled Nursing Facility3302 MANSFIELD RD
SHREVEPORT, LA 71103
(318) 222-9482

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417999780, enumerated in the NPI registry as an "organization" on June 12, 2006

The provider is located at 3302 Mansfield Rd Shreveport, La 71103 and the phone number is (318) 222-9482

This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on June 12, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.