Plymouth Life, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PLYMOUTH LIFE, INC.

Doing business as

Pride Group, Inc.

Practice address

214 Plymouth St SE
Le Mars, IA 51031-3631

Phone

(712) 546-6500

Fax

(712) 546-6589

NPI assigned

Jan 8, 2007

Last updated

Jan 28, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jillian Marie Britt

Title

HR Manager

Phone

(712) 546-6500

Specialties & licenses 3

Addresses

Other identifiers 8

Other names 1

• Pride Group, Inc. Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane D Simons, PA

  • Physician Assistant
  • Oskaloosa, IA
  • NPI 1710959051
  NPD (past)
• Anurag Gupta, MD

  • Psychiatry Physician
  • Las Vegas, NV
  • NPI 1144285552
  NPD (past)
• Richard Joseph Skorey, MD

  • Psychiatry Physician
  • Mitchell, SD
  • NPI 1225049950
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1023166576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 PLYMOUTH ST SE",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510313631",
            "telephone_number": "712-546-6500",
            "fax_number": "712-546-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 PLYMOUTH ST SE",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510313631",
            "telephone_number": "712-546-6500",
            "fax_number": "712-546-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH LIFE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "HR MANAGER",
        "authorized_official_telephone_number": "712-546-6500"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0764415",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0769471",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108423",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0741983",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0232041",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0245100",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0242990",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0251561",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pride Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abigail Penniman, RN
• Jay Vincent Penning, DC
• Darci Robin Philipp Grave
• Plains Area Mental Health, Inc.
• Plains Area Mental Health, Inc.
• Plymouth Manor Inc (Plymouth Manor Care Center)
• Ashley Powell, D.O.
• Lyndsi Price, PHARMD
• Cassandra Prieksat, CADC TEMP
• Diana Kay Rann, RN

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Le Mars, IA
• Providers in Le Mars, IA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.