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1530 Broad Avenue Operations, LLC

Skilled Nursing Facility in Gulfport, MS · enumerated 2022 · authorized official Tim Lehner, Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1306593900

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Registry record

Entity type Organization (Type 2)
Legal business name 1530 Broad Avenue Operations, LLC
Other name <Unavail>
Practice address 1530 Broad Ave, Gulfport, MS, 39501
Phone (253) 278-2258
Fax (228) 868-8544
Enumeration date Mar 4, 2022
Last updated in NPPES Sep 13, 2024

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities Primary

Authorized official

Name Tim Lehner
Title Manager
Phone (770) 698-9040

Other identifiers

Identifier Type State Issuer
000230108 Medicaid MS -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for 1530 Broad Avenue Operations, LLC?
The NPI for 1530 Broad Avenue Operations, LLC is 1306593900, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for 1530 Broad Avenue Operations, LLC?
NPPES lists Tim Lehner (Manager) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-09-13.