County of Blackhawk

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

070529 Issued in IA

Legal business name

COUNTY OF BLACKHAWK

Practice address

1410 W Dunkerton Rd
Waterloo, IA 50703-9648

Phone

(319) 291-2509

Fax

(319) 291-2570

NPI assigned

Jun 16, 2005

Organization subpart

No

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

Authorized official

Name

Douglas C. Meyer

Title

Provisional Administrator

Phone

(319) 291-2509

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Country View Doing business as

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1346245347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 W DUNKERTON RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507039648",
            "telephone_number": "319-291-2509",
            "fax_number": "319-291-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W DUNKERTON RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507039648",
            "telephone_number": "319-291-2509",
            "fax_number": "319-291-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF BLACKHAWK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-05-10",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PROVISIONAL ADMINISTRATOR",
        "authorized_official_telephone_number": "319-291-2509"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IA",
            "license": "070529",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "070529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0806984",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0181776",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country View",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Waterloo, IA
• Providers in Waterloo, 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 May 10, 2013; 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.