Madison Square Assisted Living

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

S0080 Issued in IA

Legal business name

MADISON SQUARE ASSISTED LIVING

Practice address

209 W Jefferson St
Winterset, IA 50273-1676

Phone

(515) 462-5087

Fax

(515) 462-9058

NPI assigned

Jan 7, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Stanley Birchem

Title

President/Owner

Phone

(515) 462-5087

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1245415470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W JEFFERSON ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502731676",
            "telephone_number": "515-462-5087",
            "fax_number": "515-462-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W JEFFERSON ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502731676",
            "telephone_number": "515-462-5087",
            "fax_number": "515-462-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON SQUARE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "BIRCHEM",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "515-462-5087",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IA",
            "license": "S0080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0426007",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison County Memorial Hospital
• Madison County Memorial Hospital
• Madison County Memorial Hospital
• Madison County Memorial Hospital
• Madison County Memorial Hospital
• Alexander Marett
• Savannah Marker, DO
• Gentri Meier, MS, LMHC, IADC
• Melissa Ann Merritt, APRN, FNP-C
• Darby A Messerschmitt, PHARM. D

• All providers in Winterset, IA
• Preferred Provider Organization in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.