Spring Grove Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SPRING GROVE ASSISTED LIVING LLC

Practice address

130 5TH Ave SE
Spring Grove, MN 55974-1324

Phone

(507) 498-4000

Fax

(507) 498-4001

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Nicole Kimmerle, RN, CHPN

Title

Director of Nursing Services

Phone

(507) 498-4000

Specialties & licenses 1

Addresses

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184715971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 5TH AVE SE",
            "city": "SPRING GROVE",
            "state": "MN",
            "postal_code": "559741324",
            "telephone_number": "507-498-4000",
            "fax_number": "507-498-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 5TH AVE SE",
            "city": "SPRING GROVE",
            "state": "MN",
            "postal_code": "559741324",
            "telephone_number": "507-498-4000",
            "fax_number": "507-498-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING GROVE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIMMERLE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING SERVICES",
        "authorized_official_telephone_number": "507-498-4000",
        "authorized_official_credential": "RN, CHPN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent School District #297
• Rushford Drug Company
• Charity Lyn Schroeder, OTR/L
• Amanda Rae Schuttemeier, PHARMD
• Spring Grove Ambulance Corporation
• Spring Grove Family Chiropractic, PA
• The Reflective Haven LLC
• Molly E Thomas, NP
• Gregory N Tjossem, M.D.
• Tweeten Lutheran Healthcare Center, Inc

• All providers in Spring Grove, MN
• Assisted Living Facility in Minnesota

• 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.