Organization Active NPI

Green Meadows Senior Living, LLC

  • Assisted Living Facility
  • Johnston, IA
National Provider Identifier
1194190595
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GREEN MEADOWS SENIOR LIVING, LLC
Practice address
6750 Corporate Dr
Johnston, IA 50131-1659
Phone
(515) 207-1984
Fax
(515) 777-2376
NPI assigned
Dec 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Authorized official

Name
Mrs. Pat Hanson, RN
Title
Manager
Phone
(515) 207-1984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

6750 Corporate Dr
Johnston, IA 50131-1659

Mailing address

6750 Corporate Dr
Johnston, IA 50131-1659
Phone (515) 207-1984

Other names 1

  • Edencrest at Green Meadows Doing business as

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
16D2107867Edencrest at Green Meadows6750 Corporate Drive, Johnston, IA 50131Certificate of waiverJan 24, 2028

National Provider Directory

National Provider Directory
Tax ID family
Courtyard Estates at Cedar Pointe2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1194190595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 CORPORATE DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311659",
            "telephone_number": "515-207-1984",
            "fax_number": "515-777-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 CORPORATE DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311659",
            "telephone_number": "515-207-1984",
            "fax_number": "515-777-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MEADOWS SENIOR LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "515-207-1984",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edencrest at Green Meadows",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.