Fairbury Assisted Living Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALF281 Issued in NE

Legal business name

FAIRBURY ASSISTED LIVING FACILITY

Practice address

828 22ND St
Fairbury, NE 68352-1202

Phone

(402) 729-3351

Fax

(402) 729-2102

NPI assigned

May 26, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Chad Jurgens

Title

Secretary

Phone

(402) 729-3351

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cedarwood Assisted Living Facility 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

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1134412992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 22ND ST",
            "city": "FAIRBURY",
            "state": "NE",
            "postal_code": "683521202",
            "telephone_number": "402-729-3351",
            "fax_number": "402-729-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 22ND ST",
            "city": "FAIRBURY",
            "state": "NE",
            "postal_code": "683521202",
            "telephone_number": "402-729-3351",
            "fax_number": "402-729-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBURY ASSISTED LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "JURGENS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "402-729-3351",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NE",
            "license": "ALF281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250579-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedarwood Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catrina Cude
• Custom Prescriptions Inc.
• Shelby Ann Davis
• Jerold Edward Ebke, DDS
• Lisa A Edeal, RD
• Fairbury Clinic, P.C.
• Fairbury Dental Associates, P.C.
• Fairbury Public Schools
• Carolyn A Ferguson, APRN
• Renae Folkers

• Assisted Living Facility in Fairbury, NE
• Providers in Fairbury, NE by specialty
• Assisted Living Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.