Country Aire Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COUNTRY AIRE OPCO, LLC

Doing business as

Country Aire Retirement Center

Practice address

18540 State Highway 16
Lewistown, MO 63452-2111

Phone

(573) 215-2216

NPI assigned

Dec 16, 2018

Last updated

Dec 16, 2018By 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

Sam Stern

Title

Cfo

Phone

(877) 567-0402

Specialties & licenses 3

Addresses

Other names 1

• Country Aire Retirement Center Doing business as

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544918400000",
    "number": "1376014423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST STE 220",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "877-567-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18540 STATE HIGHWAY 16",
            "city": "LEWISTOWN",
            "state": "MO",
            "postal_code": "634522111",
            "telephone_number": "573-215-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY AIRE OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Aire Retirement Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anita Lyn Arnold, FNP-C
• Penny Elizabeth Buening, APRN
• Karen Joy Abando Cordova
• Country Aire Healthcare LLC (Country Aire Retirement Center)
• Country Aire Operations Management LLC
• Deaconess Long Term Care of Missouri, Inc. (Country Aire Retirement Estates)
• Michelle Ebeling, M.A., CCC-SLP
• GX2 LLC (MED-Direct)
• Tanya Lee Jones, MSW

• Skilled Nursing Facility in Lewistown, MO
• Providers in Lewistown, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.