Premier Estates 506, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

520052 Issued in IA

Legal business name

PREMIER ESTATES 506, LLC

Practice address

3661 Rochester Ave
Iowa City, IA 52245-9271

Phone

(319) 351-7460

Fax

(319) 354-8428

NPI assigned

Jan 11, 2016

Organization subpart

No

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

Authorized official

Name

Cassidy Bancroft

Title

Controller

Phone

(941) 758-4745

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1083070783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085509",
            "telephone_number": "941-758-4745",
            "fax_number": "941-751-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 ROCHESTER AVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522459271",
            "telephone_number": "319-351-7460",
            "fax_number": "319-354-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ESTATES 506, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "BANCROFT",
        "authorized_official_first_name": "CASSIDY",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "941-758-4745"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "520052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800179",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassie Marie Pratt, PA-C
• Elayne Janette Pregon, MSN ARNP FNP-C
• Jennifer Preinitz
• Prelude Behavioral Services
• Prelude Behavioral Services
• Marcus E Pressler, MD
• Kelly Lynne McGee Preuninger, ARNP, DNP
• Jeffery Glen Pribble
• Steven Paul Price, DDS
• Jamison Prickett, ARNP

• Skilled Nursing Facility in Iowa City, IA
• Providers in Iowa City, 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 Jan 9, 2018; 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.