Keystone North Liberty, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

KEYSTONE NORTH LIBERTY, LLC

Practice address

1275 W Forevergreen Rd
North Liberty, IA 52317-8533

Phone

(319) 459-1964

Fax

(319) 626-2661

NPI assigned

Sep 8, 2020

Organization subpart

No

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

Authorized official

Name

Brenda L Armstrong

Title

General Counsel

Phone

(317) 409-9252

Specialties & licenses 1

Addresses

Other names 1

• Keystone Place at Forevergreen Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Breanna Leigh Bender, PT, DPT

  • Physical Therapist
  • Coralville, IA
  • NPI 1730587858
  NPD (past)

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1295349207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 AIRPORT DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545845",
            "telephone_number": "317-409-9252",
            "fax_number": "317-863-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 W FOREVERGREEN RD",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178533",
            "telephone_number": "319-459-1964",
            "fax_number": "319-626-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE NORTH LIBERTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "317-409-9252"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keystone Place at Forevergreen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica L Keeran, DPT
• Tyler Philip Kempf, ARNP
• Kengard Enterprises LLC
• Cameron G Kerl, MD
• Sandra Lea Kessler, LISW
• Julie Anne King, LISW
• Molly Kay King, DPT, ATC
• Bergynn Marie Kareen Kinnison
• Carlen Knapp
• Katheryn Kolker

• Assisted Living Facility in North Liberty, IA
• Providers in North Liberty, IA by specialty
• Assisted Living Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.