NPIMap

Organization Active NPI

Sunset Park Place Co

  • Assisted Living Facility
  • Dubuque, IA
National Provider Identifier
1114137601
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
S0127 Issued in IA
Legal business name
SUNSET PARK PLACE CO
Practice address
3730 Pennsylvania Ave
Dubuque, IA 52002-3701
Phone
(563) 583-7939
Fax
(563) 583-2982
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jerry Bell
Title
Manager
Phone
(563) 583-7939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X S0127 IA Primary

Addresses

Primary practice location

3730 Pennsylvania Ave
Dubuque, IA 52002-3701

Mailing address

3730 Pennsylvania Ave
Dubuque, IA 52002-3701
Phone (563) 583-7939

Other identifiers 1

IdentifierTypeStateIssuer
0478701MedicaidIA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114137601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 PENNSYLVANIA AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023701",
            "telephone_number": "563-583-7939",
            "fax_number": "563-583-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 PENNSYLVANIA AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023701",
            "telephone_number": "563-583-7939",
            "fax_number": "563-583-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET PARK PLACE CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "563-583-7939"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": "S0127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0478701",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.