JP Manor LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

760036 Issued in IA

Legal business name

JP MANOR LLC

Doing business as

Pocahontas Manor

Practice address

700 NW 7TH St
Pocahontas, IA 50574-2206

Phone

(712) 335-3387

Fax

(712) 335-4009

NPI assigned

Aug 24, 2012

Last updated

Aug 24, 2012By 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. Joseph Patrick Dewitt

Title

Vice President

Phone

(712) 754-7312

Specialties & licenses 1

Addresses

Other names 1

• Pocahontas Manor Doing business as

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

{
    "created_epoch": "1345766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345766400000",
    "number": "1336497304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3913 SYLVIAN AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511041325",
            "telephone_number": "712-574-7312",
            "fax_number": "712-277-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NW 7TH ST",
            "city": "POCAHONTAS",
            "state": "IA",
            "postal_code": "505742206",
            "telephone_number": "712-335-3387",
            "fax_number": "712-335-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JP MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-24",
        "last_updated": "2012-08-24",
        "status": "A",
        "authorized_official_last_name": "DEWITT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "712-754-7312",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "760036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pocahontas Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Pocahontas, IA
• Providers in Pocahontas, 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 24, 2012; 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.