Monticello Nursing Home Company LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

S0110 Issued in IA

Legal business name

MONTICELLO NURSING HOME COMPANY LLC

Doing business as

Pennington Square Assisted Living

Practice address

502 Pinehaven Dr
Monticello, IA 52310-2062

Phone

(319) 465-2013

Fax

(319) 465-3205

NPI assigned

Apr 11, 2007

Last updated

Aug 22, 2020By 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

Mr. Donald L Chensvold

Title

Manager

Phone

(319) 362-8916

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pennington Square Assisted Living Doing business as

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

Monticello Nursing Home Company LLC3 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.

• Monticello Nursing Home Company

  dba Monticello Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Monticello, IA
  • NPI 1649239492
  NPD tax ID
• Monticello Nursing Home Company LLC

  dba Monticello Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Monticello, IA
  • NPI 1346467651
  NPD tax ID

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104049717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 PINEHAVEN DR",
            "city": "MONTICELLO",
            "state": "IA",
            "postal_code": "523102062",
            "telephone_number": "319-465-2013",
            "fax_number": "319-465-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 PINEHAVEN DR",
            "city": "MONTICELLO",
            "state": "IA",
            "postal_code": "523102062",
            "telephone_number": "319-465-2013",
            "fax_number": "319-465-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO NURSING HOME COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHENSVOLD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "319-362-8916",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": "S0110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280636",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pennington Square Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsey Meyer, DDS
• Nicole Monk-Stoneking
• Monticello Community School District
• Monticello Family Dentistry, P.C.
• Monticello Nursing Home Company (Monticello Nursing & Rehabilitation Center)
• Monticello Nursing Home Company LLC (Monticello Nursing & Rehabilitation Center)
• Nightingale Pharmacy 1St LLC (Nightingale Drug)
• Daniel James Noonan, LMSW
• Kelly Jo O'Reilly Alber, ARNP, FNP-BC
• Peace of Mind Therapy LLC

• Assisted Living Facility in Monticello, IA
• Providers in Monticello, IA by specialty
• Assisted Living Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.