NPIMap

Organization Active NPI

Rem Iowa, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Cedar Rapids, IA
National Provider Identifier
1114089539
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
REM IOWA, INC
Practice address
29 36TH Ave SW
Cedar Rapids, IA 52404-4641
Phone
(319) 364-7177
Fax
(319) 364-7598
NPI assigned
Dec 14, 2006
Last updated
Jun 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
VP & Sr. Asst General Counsel
Phone
(952) 836-2234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

29 36TH Ave SW
Cedar Rapids, IA 52404-4641

Mailing address

1220 Industrial Ave Ste C
Hiawatha, IA 52233-1118
Phone (319) 393-1944

Other identifiers 1

IdentifierTypeStateIssuer
0880492MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114089539. Details of each certification follow.

  • CCN 16G033 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 16G033

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
REM IOWA-36TH AVENUE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 21, 1989
Last certification
Nov 26, 2024
Beds
8
Ownership / control type
Other (specify)
Facility address
29 36TH Avenue S W
Cedar Rapids, IA 52404

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2339607Rem Iowa - 36TH Ave29 36TH Ave SW, Cedar Rapids, IA 52404Certificate of waiverMar 3, 2028

National Provider Directory

National Provider Directory
Tax ID family
Rem Iowa Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719100800000",
    "number": "1114089539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 INDUSTRIAL AVE STE C",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522331118",
            "telephone_number": "319-393-1944",
            "fax_number": "319-393-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 36TH AVE SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524044641",
            "telephone_number": "319-364-7177",
            "fax_number": "319-364-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM IOWA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "VP & SR. ASST GENERAL COUNSEL",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0880492",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.