Simpson Memorial Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

703215 Issued in IA

Legal business name

SIMPSON MEMORIAL HOME INC

Doing business as

Wilton Retirement Community

Practice address

307 Ovesen Dr
Wilton, IA 52778-9568

Phone

(563) 732-5067

Fax

(563) 732-5068

NPI assigned

Sep 13, 2013

Last updated

May 11, 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

Derwood G Keith

Title

President

Phone

(319) 627-4775

Specialties & licenses 1

Addresses

Other names 1

• Wilton Retirement Community Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033544655. Details of each certification follow.

• CCN 165611 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 165611

Legal name

SIMPSON MEMORIAL HOME INC

Doing business as

WILTON RETIREMENT COMMUNITY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 14, 2014

Last certification

Oct 10, 2024

Beds

34

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Simpson Memorial Home Inc

Organization structure

CorporationNon-profit

Enrollment address

307 Ovesen Dr
Wilton, IA 52778-9568

Nursing home name

WILTON RETIREMENT COMMUNITY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Simpson Memorial Home Inc

  • Skilled Nursing Facility
  • West Liberty, IA
  • NPI 1033106620

  7315961331

  Same PAC ID

Listed as

Wilton Retirement CommunityCCN 165611 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Oct 14, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3430.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Leland Smith Assisted Living3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Simpson Memorial Home Inc

  • Skilled Nursing Facility
  • West Liberty, IA
  • NPI 1033106620
  NPD tax ID
• Simpson Memorial Home, Inc

  dba Leland Smith Assisted Living

  • Assisted Living Facility
  • Wilton, IA
  • NPI 1114055910
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• William Burke LTD

  dba Main at Locust Pharmacy

  • Community/Retail Pharmacy
  • Davenport, IA
  • NPI 1184781940

  Member Of

  NPD member

Locations

All disclosed owners & managing parties 72

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Blue Stone Therapy Inc.

  • Physical Medicine & Rehabilitation Physician
  • Urbandale, IA
  • NPI 1932797297

  Adp of the SNF

  CMS ownership
• Samuel Orvis, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Iowa City, IA
  • NPI 1962025593

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• William Burke LTD

  dba Main at Locust Pharmacy

  • Community/Retail Pharmacy
  • Davenport, IA
  • NPI 1184781940

  Adp of the SNF, Indirect Ownership Interest

  CMS ownership
• William Burke LTD

  dba Main at Locust Pharmacy and Clinic

  • Clinic Pharmacy
  • Davenport, IA
  • NPI 1851620066

  Adp of the SNF, Indirect Ownership Interest

  CMS ownership

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1033544655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 OVESEN DR",
            "city": "WILTON",
            "state": "IA",
            "postal_code": "527789568",
            "telephone_number": "563-732-5067",
            "fax_number": "563-732-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 OVESEN DR",
            "city": "WILTON",
            "state": "IA",
            "postal_code": "527789568",
            "telephone_number": "563-732-5067",
            "fax_number": "563-732-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPSON MEMORIAL HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "DERWOOD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-627-4775"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "703215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilton Retirement Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sherri L Macgowan, DC
• Rachael Martin, PT
• Lisa Michaels, DC
• Melanie Elizabeth Hexen Retterer, CPM
• Laura Fitzpatrick Sass Meincke, DDS
• Simpson Memorial Home, Inc (Leland Smith Assisted Living)
• Matthew Lynn Sojka, M.D.
• Annie Springsteen, PHARM.D.
• Keith Wayne Stanley, DDS
• Jason Daniel Thornburg, PA-C

• Skilled Nursing Facility in Wilton, IA
• Providers in Wilton, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.