Diversicare of Canon City, LLC
NPI 1497134456 · Skilled Nursing Facility · Canon City, CO
Diversicare of Canon City, LLC is a Skilled Nursing Facility organization in Canon City, CO (NPI 1497134456).
Provider details
- NPI number
- 1497134456
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Parent organization
- Diversicare Leasing Company II, LLC
- Organization subpart
- Yes
- Authorized official
- Kelly Gill, President & Ceo(615) 771-7575
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Diversicare of Canon City
Registry dates
- Enumerated
- 2015-05-23
- Last updated
- 2015-05-23
Frequently asked questions
- What is Diversicare of Canon City, LLC's NPI number?
- Diversicare of Canon City, LLC's National Provider Identifier (NPI) is 1497134456, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Diversicare of Canon City, LLC?
- Diversicare of Canon City, LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is Diversicare of Canon City, LLC located?
- Diversicare of Canon City, LLC's practice location on file with NPPES is 515 Fairview Ave, Canon City, CO 81212-2863.
- What is Diversicare of Canon City, LLC's phone number?
- The practice phone number listed in the NPPES registry for Diversicare of Canon City, LLC is (719) 275-0665.
- Who is the authorized official for Diversicare of Canon City, LLC?
- The authorized official listed on Diversicare of Canon City, LLC's NPPES record is Kelly Gill, President & Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Diversicare of Canon City, LLC's NPI active?
- Yes — Diversicare of Canon City, LLC's NPI (1497134456) is active in the NPPES registry as of the last update on 2015-05-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.