NPIMap

Organization Active NPI

Madrid Home for the Aging

Doing business as Ballard Creek Community

  • Assisted Living Facility
  • Huxley, IA
National Provider Identifier
1346312683
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
S0007 Issued in IA
Legal business name
MADRID HOME FOR THE AGING
Doing business as
Ballard Creek Community
Practice address
908 N US Highway 69
Huxley, IA 50124-9764
Phone
(515) 597-2555
Fax
(515) 597-3877
NPI assigned
Nov 14, 2006
Last updated
Jul 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
MADRID HOME FOR THE AGINGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Authorized official

Name
Kris J Hansen
Title
President
Phone
(515) 795-3007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X S0007 IA Primary

Addresses

Primary practice location

908 N US Highway 69
Huxley, IA 50124-9764

Mailing address

908 N US Highway 69
Huxley, IA 50124-9764
Phone (515) 597-2555

Other identifiers 1

IdentifierTypeStateIssuer
0178210MedicaidIA

Other names 1

  • Ballard Creek Community Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Madrid Home for the Agi4 organizations share this tax ID, including this one
Part of
Madrid Home for the Agi

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1346312683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 N US HIGHWAY 69",
            "city": "HUXLEY",
            "state": "IA",
            "postal_code": "501249764",
            "telephone_number": "515-597-2555",
            "fax_number": "515-597-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N US HIGHWAY 69",
            "city": "HUXLEY",
            "state": "IA",
            "postal_code": "501249764",
            "telephone_number": "515-597-2555",
            "fax_number": "515-597-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRID HOME FOR THE AGING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADRID HOME FOR THE AGING",
        "enumeration_date": "2006-11-14",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "KRIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-795-3007"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": "S0007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0178210",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballard Creek Community",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ballard Creek Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huxley, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.