Rotary Club of Eagle Grove Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

990337 Issued in IA

Legal business name

ROTARY CLUB OF EAGLE GROVE HOME INC

Practice address

500 S Blaine Ave
Eagle Grove, IA 50533-2429

Phone

(515) 448-5123

NPI assigned

Oct 7, 2005

Last updated

Aug 11, 2010By 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

Stephanie Morris

Title

Administrator

Phone

(515) 448-5124

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Rotary Ann Nursing Home Other name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043208671. Details of each certification follow.

• CCN 165500 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 165500

Legal name

ROTARY CLUB OF EAGLE GROVE HOME INC

Doing business as

ROTARY SENIOR LIVING

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 15, 2003

Last certification

Jun 12, 2025

Beds

46

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Enrollment address

500 S Blaine Ave
Eagle Grove, IA 50533-2429

Nursing home name

ROTARY SENIOR LIVING

Listed as

Rotary Senior LivingCCN 165500 · All quality measures

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Oct 15, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4630.5 residents per day on average

Penalties (3 years)

1Fines totaling $65,036

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

All disclosed owners & managing parties 7

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 1

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

• Dustin R Smith, MD

  • Family Medicine Physician
  • Eagle Grove, IA
  • NPI 1134191018

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Michael Joseph McLoughlin, MD

  • Internal Medicine Physician
  • Clarion, IA
  • NPI 1467890376

  Nursing home

  Care Compare affiliation
• Dustin R Smith, MD

  • Family Medicine Physician
  • Eagle Grove, IA
  • NPI 1134191018

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1043208671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SE 5TH ST",
            "city": "EAGLE GROVE",
            "state": "IA",
            "postal_code": "505332477",
            "telephone_number": "515-448-5124",
            "fax_number": "515-448-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S BLAINE AVE",
            "city": "EAGLE GROVE",
            "state": "IA",
            "postal_code": "505332429",
            "telephone_number": "515-448-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROTARY CLUB OF EAGLE GROVE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "515-448-5124"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "IA",
            "license": "990615",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "990337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0803536",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0891549",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rotary Ann Nursing Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jordan Michael Moffitt, DDS
• Michael W Moffitt, DDS
• Mother Ship LLC (Moffitt Dental)
• Parrott Family Chiropractic, P.C. (Eagle Grove Chiropractic)
• Aaron Michael Parrott, D.C.
• Elizabeth Schwake, MT-BC
• Jordan Sisson, MS. ED
• Dustin R Smith, MD
• Trimark Physicians Group (UnityPoint Clinic)
• Trimark Physicians Group Inc (Trimark Physicians Group)

• Skilled Nursing Facility in Eagle Grove, IA
• Providers in Eagle Grove, 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 Aug 11, 2010; 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.