PREMIER ESTATES 506, LLC (NPI# 1083070783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083070783 |
| Entity Type | Organization |
| Organization Name | PREMIER ESTATES 506, LLC |
| Practice Address |
3661 Rochester Ave Iowa City IA 52245-9271 |
| Mailing Address |
5115 E State Road 64 Bradenton FL 34208-5509 |
| Practice Telephone | 3193517460 |
| Practice Fax Number | 3193548428 |
| Mailing Telephone | 9417584745 |
| Mailing Fax Number | 9417512135 |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2018-01-09 |
| Authorized Official Name | CASSIDY BANCROFT (CONTROLLER) |
| Authorized Official Telephone | 9417584745 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 520052 | IA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0800179 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | PREMIER ESTATES 506, LLC | 5115 E State Rd 64, Bradenton, FL 34208 |
| Street Address |
3661 ROCHESTER AVE |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52245-9271 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740271279 | The Waverley Group, Inc. | Skilled Nursing Facility | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2005-11-03 |
| 1619334109 | Ashley Jackson | Occupational Therapy Assistant | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2016-01-28 |
| 1518366061 | Iowa City Care Center, Inc. | Skilled Nursing Facility | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2014-08-21 |
| 1811269897 | Ruth Bradley | Speech-Language Pathologist | 3661 Rochester Ave, Iowa City, IA 52245 | 2012-02-06 |
| 1568635035 | Brenda Sue Oehlerich | Physical Therapy Assistant | 3661 Rochester Ave, Iowa City, IA 52245 | 2008-04-07 |
| 1982883310 | Kelly Ann Strait | Occupational Therapy Assistant | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2007-11-01 |
| 1972798247 | Jamie Sue Sickels | Occupational Therapy Assistant | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2007-09-10 |
| 1891991790 | Christine Marie Mccusker | Physical Therapist | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2007-06-26 |
| 1740486695 | Heather Rae Padgett | Physical Therapy Assistant | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2007-06-26 |
| 1679779557 | Kathryn Ann Kurk | Occupational Therapist | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2007-06-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730699356 | Mary Beth Shapcott | Registered Nurse | 500 East Market St., Mercy Hospital Diabetes Education, Iowa City, IA 52245 | 2017-10-10 |
| 1366703167 | Elizabeth Bright | Occupational Therapist | 540 E. Jefferson Street., Ste.302, Iowa City, IA 52245 | 2012-06-07 |
| 1043518368 | Robert Brian Goffstein | Ophthalmology | 403 North 7th Ave, Iowa City, IA 52245 | 2011-03-10 |
| 1750682936 | Robert Alvin Blair | Dentist | 134 Broadmoor Lane, Iowa City, IA 52245 | 2010-11-04 |
| 1215167457 | Laura J Ericson | Occupational Therapist | 540 E Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-07-22 |
| 1780818294 | Kathryn Leigh Bossen | Physical Therapist | 540 E. Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-05-12 |
| 1073751095 | Jessica L Keeran | Physical Therapist | 2751 Northgate Dr. Ne, Iowa City, IA 52245 | 2009-01-29 |
| 1437330370 | Francine Mardarello Hunnicutt | Marriage & Family Therapist | 1610 East College St, Iowa City, IA 52245 | 2007-11-20 |
| 1659574853 | Joan Victoria Rinner | Marriage & Family Therapist | 121 University Services Building, University of Iowa, Iowa City, IA 52245 | 2007-06-06 |
| 1053529966 | Steve Bernt Hammerstrom | Chiropractor | 373 B Scott Court, Iowa City, IA 52245 | 2007-05-21 |
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| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | 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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871523027 | Christian Retirement Services Inc | Skilled Nursing Facility | 1 Oaknoll Ct, Iowa City, IA 52246-5250 | 2006-07-04 |
| 1740271279 | The Waverley Group, Inc. | Skilled Nursing Facility | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2005-11-03 |
| 1518366061 | Iowa City Care Center, Inc. | Skilled Nursing Facility | 3661 Rochester Ave, Iowa City, IA 52245-9271 | 2014-08-21 |
| 1053611707 | Briarwood Management Inc | Skilled Nursing Facility | 605 Greenwood Dr, Iowa City, IA 52246-2121 | 2010-10-28 |
| 1225364508 | Covenant Care Greenwood LLC | Skilled Nursing Facility | 605 Greenwood Dr, Iowa City, IA 52246-2121 | 2009-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647165 | Ema Rehabilitation, LLC | Skilled Nursing Facility | 1831 E Kanesville Blvd, Council Bluffs, IA 51503-4767 | 2020-10-22 |
| 1770198855 | Wellspire-bettendorf LLC | Skilled Nursing Facility | 4699 53rd Ave, Bettendorf, IA 52722 | 2020-09-15 |
| 1114547395 | Bvm-phs Senior Housing Inc | Skilled Nursing Facility | 1160 Carmel Dr, Dubuque, IA 52003-7911 | 2020-04-17 |
| 1659920320 | Phs Walnut Ridge LLC | Skilled Nursing Facility | 1703 Campus Drive, Clive, IA 50325 | 2019-09-05 |
| 1992354666 | Phs Council Bluffs, Inc | Skilled Nursing Facility | 16 Valley View Drive, Council Bluffs, IA 51503 | 2019-09-05 |
| 1023679057 | Bcp Union Park, LLC | Skilled Nursing Facility | 2401 E 8th St, Des Moines, IA 50316-1717 | 2019-06-20 |
| 1639637143 | Wellspire LLC | Skilled Nursing Facility | 5508 Nw 88th St, Johnston, IA 50131-3005 | 2019-03-05 |
| 1356807101 | Accura Healthcare of Aurelia LLC | Skilled Nursing Facility | 401 W 5th St, Aurelia, IA 51005-7712 | 2019-02-18 |
| 1093286395 | Ccrc of West Des Moines, LLC | Skilled Nursing Facility | 8950 Coachlight Drive, West Des Moines, IA 50266 | 2018-12-12 |
| 1255828919 | Brio of Johnston, LLC | Skilled Nursing Facility | 6901 Peckham St, Johnston, IA 50131-3143 | 2018-04-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.