PARK PLACE – NPI #1265973457
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.

PARK PLACE is a skilled nursing facility (SNF) located in SELMA, AL. NPPES has assigned the NPI number 1265973457 to PARK PLACE on March 20, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PARK PLACE” is a dba name, the actual legal business name for this organization is DIVERSICARE OF SELMA, LLC. The primary taxonomy selected by this provider is 314000000X from the Health Care Provider Taxonomy code set, which is classified as Skilled Nursing Facility.

The NPI profile was previously updated about 3 years ago on Apr 07, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PARK PLACE below.

NPI Profile for
DIVERSICARE OF SELMA, LLC

NPI Number
1265973457
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DIVERSICARE OF SELMA, LLC
Doing Business As (dba): PARK PLACE
Primary location
100 PARK PL
SELMA, AL 36701
Phone: (334) 872-3471 Fax: (334) 872-8923
Mailing address
1621 GALLERIA BLVD
BRENTWOOD, TN 37027-2926
Phone: (615) 550-9453 Fax: (615) 915-6935
Organization Subpart
Yes - PARK PLACE is subpart of another organization.
Authorized Official
MATTHEW WEISHAAR
CHIEF FINANCIAL OFFICER
Phone: (615) 550-9459
Updated
Certification Date
Apr 07, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for PARK PLACE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidAL206565
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
314000000X
- Skilled Nursing Facility (Primary)
AL N2402

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.