Covenant Healthcare, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3195 Issued in WI

Legal business name

COVENANT HEALTHCARE, LLC

Doing business as

Dove Healthcare - West

Practice address

1405 Truax Blvd
Eau Claire, WI 54703-1474

Phone

(175) 552-1030

Fax

(715) 552-1033

NPI assigned

Jul 19, 2005

Last updated

Nov 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James P. Deignan, NHA, CPA

Title

Executive Director/Ceo

Phone

(715) 552-1030

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dove Healthcare - West Doing business as

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1215936430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 TRUAX BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547031474",
            "telephone_number": "175-552-1030",
            "fax_number": "715-552-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 TRUAX BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547031474",
            "telephone_number": "175-552-1030",
            "fax_number": "715-552-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "DEIGNAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "715-552-1030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA, CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3195",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41480100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20178200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dove Healthcare - West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Costco Wholesale Corporation (Costco Hearing Aid #1664)
• Anna W Cothron, MD
• County of Eau Claire
• Zachary Thomas Couture, APNP
• Matthew Cove, MD
• Jo Mary Cowan, PT
• Lauren Ann Cowper, DDS
• Eva R Cox, RN
• Jessica R Craft, SAC-IT
• Gabrielle Marie Craig

• Skilled Nursing Facility in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.