COLONIAL MANORS OF FAYETTE, INC (NPI# 1801889811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801889811 |
| Entity Type | Organization |
| Organization Name | COLONIAL MANORS OF FAYETTE, INC |
| Other Organization Name | MAPLE CREST MANOR & ASSISTED LIVING |
| Practice Address |
100 Bolger Dr Fayette IA 52142-9762 |
| Practice Telephone | 5634253336 |
| Practice Fax Number | 5634253512 |
| Mailing Telephone | 5634253336 |
| Mailing Fax Number | 5634253512 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2011-09-14 |
| Authorized Official Name | DEBRA J HELDT (NURSING HOME ADMINISTRATOR) |
| Authorized Official Telephone | 5634253336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | S0204 | IA | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 330221 | IA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0802470 | 05 |
| Other Name | Type Code |
|---|---|
| Maple Crest Manor & Assisted Living | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | COLONIAL MANORS OF FAYETTE, INC | 100 Bolger Dr, Fayette, IA 52142 |
| Street Address |
100 BOLGER DR |
| City | FAYETTE |
| State | IA |
| Zip Code | 52142-9762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306364997 | Kyle James Domin | Specialist/Technologist | 605 Washington Street, Fayette, IA 52142 | 2017-09-02 |
| 1114372752 | Ryan Scott Fonkert | Specialist/Technologist | 605 Washingtone Street, Fayette, IA 52142 | 2016-05-02 |
| 1487871273 | Total Builders | Durable Medical Equipment & Medical Supplies | 210 S. Main St., Box 698, Fayette, IA 52142 | 2007-04-20 |
| 1053366518 | Gundersen Clinic, Ltd. | Clinic/Center | 110 King Street, Fayette, IA 52142 | 2006-05-23 |
| 1811992548 | Steven W Greenwaldt | Physician Assistant | 110 King Street, Fayette, IA 52142-0157 | 2005-06-17 |
| 1649205469 | City of Fayette | Ambulance | 11 South Main, Fayette, IA 52142-0340 | 2006-07-11 |
| 1316044654 | Kirk A Abernathy | Chiropractor | 139 South Main Street, Fayette, IA 52142-0578 | 2006-09-20 |
| 1639444235 | Charming Smiles PC | Clinic/Center | 143 S Main St, Fayette, IA 52142-7701 | 2012-03-14 |
| 1902464415 | Takuya Suzuki | Specialist/Technologist | 400 Jones St, Fayette, IA 52142-9180 | 2019-05-30 |
| 1245857515 | Winneshiek Medical Center | Clinic/Center | 605 Washington St, Fayette, IA 52142-9206 | 2020-07-02 |
| Find all providers in zip 52142 | ||||
| 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 |
|---|---|---|---|---|
| 1174519474 | N & R of Fayette, Inc. | Skilled Nursing Facility | 501 S Park Ave, Fayette, MO 65248-8952 | 2005-09-22 |
| 1184611741 | Jefferson County Nursing Home | Skilled Nursing Facility | 910 Main St, Fayette, MS 39069-5524 | 2005-09-29 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.