Organization Active NPI

Anamosa Nursing Home Company LLC

Doing business as Woodland Park Assisted Living

  • Assisted Living Facility
  • Anamosa, IA
National Provider Identifier
1225256910
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
S0253 Issued in IA
Legal business name
ANAMOSA NURSING HOME COMPANY LLC
Doing business as
Woodland Park Assisted Living
Practice address
1207 East Third Street
Anamosa, IA 52205-1503
Phone
(319) 462-2668
Fax
(319) 462-3705
NPI assigned
Apr 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Mr. Donald L Chensvold
Title
Manager
Phone
(319) 362-8916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X S0253 IA Primary

Addresses

Primary practice location

1207 East Third Street
Anamosa, IA 52205-1503

Mailing address

1207 East Third Street
Anamosa, IA 52205-1503
Phone (319) 462-2668

Other identifiers 1

IdentifierTypeStateIssuer
0747832MedicaidIA

Other names 1

  • Woodland Park Assisted Living 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
16D1065177Woodland Park Assisted Living1207 East Third Street, Anamosa, IA 52205Certificate of waiverFeb 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Anamosa Care Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225256910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 EAST THIRD STREET",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522051503",
            "telephone_number": "319-462-2668",
            "fax_number": "319-462-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 EAST THIRD STREET",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522051503",
            "telephone_number": "319-462-2668",
            "fax_number": "319-462-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAMOSA NURSING HOME COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHENSVOLD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "319-362-8916",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": "S0253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0747832",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodland Park Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anamosa, 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.
  • 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.