# PIONEER TRACE GROUP, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285186924
- **Authorized official:** MRS. KIMBERLY SMITH NHA (CFO/MEMBER)
- **Authorized official phone:** (270) 839-1589

## Contact information

- **Practice address:** 115 PIONEER TRCE, FLEMINGSBURG, KY 41041-9665
- **Practice address phone:** (606) 845-2131
- **Practice address fax:** (606) 845-3507
- **Mailing address:** 115 PIONEER TRCE, FLEMINGSBURG, KY 41041-9665
- **Mailing address phone:** (606) 845-2131
- **Mailing address fax:** (606) 845-3507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100484 | KY | Yes |

## Other

- **Enumeration date:** 10/28/2016
- **Last updated:** 11/01/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 100484 | FACILITY LICENSE | KY |