Fairway View of Senior Community

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

328664 Issued in MN

Legal business name

FAIRWAY VIEW OF SENIOR COMMUNITY

Practice address

215 Lundell Ave
Ortonville, MN 56278-4516

Phone

(952) 888-2923

NPI assigned

Apr 26, 2006

Last updated

Jun 25, 2008By 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

Howie Groff

Title

President

Phone

(952) 888-2923

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1295792000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 LUNDELL AVE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562784516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 LUNDELL AVE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562784516",
            "telephone_number": "952-888-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWAY VIEW OF SENIOR COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "GROFF",
        "authorized_official_first_name": "HOWIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-888-2923"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "328664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALHCP",
            "identifier": "328664",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HWS",
            "identifier": "329312",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "050606005",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "861473300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan Scott Delage, MD
• Corinne Dohman
• Tracy Lynn Dozak, NP-C
• Dr Ronn McDaniel PA
• Stephen Thomas Erlandson, DPT
• Fairway View Senior Community
• Neil Feist, P.T.
• Kayla Jo Findlay, PT
• Sarah Fischer, MD
• Granite Falls Eyecare, Inc (Ortonville Family Eyecare)

• Assisted Living Facility in Ortonville, MN
• Providers in Ortonville, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.