Signature Properties of Council Bluffs LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

780151 Issued in IA

Legal business name

SIGNATURE PROPERTIES OF COUNCIL BLUFFS LLC

Doing business as

Woodlands Rehabilitation Center

Practice address

1600 McPherson Ave
Council Bluffs, IA 51503-4858

Phone

(712) 322-9285

Fax

(712) 322-7771

NPI assigned

Nov 15, 2005

Last updated

Aug 30, 2010By 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. Bruce Mehlhop

Title

Managing Member

Phone

(515) 727-1768

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodlands Rehabilitation Center Doing business as

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1275515405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MCPHERSON AVE",
            "address_2": "WOODLANDS REHABILITATION CENTER",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034858",
            "telephone_number": "712-322-9285",
            "fax_number": "712-322-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MCPHERSON AVE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034858",
            "telephone_number": "712-322-9285",
            "fax_number": "712-322-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE PROPERTIES OF COUNCIL BLUFFS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "MEHLHOP",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "515-727-1768",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "780151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0809699",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodlands Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathan Charles Shumway, D.P.M.
• Cindy Marie Shupe, MSN, FNP-C
• Bailee Shupp, PT
• Casey Sicuso
• Elvin Dean Siebert, LISW
• Timothy Ryan Silvestri, CPHT
• Brittany Victoria Simon, MD
• Sarah Simpson
• Harmit Singh, MD
• Maryann Slack

• Skilled Nursing Facility in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.