Fair Oaks RCF, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

730994 Issued in IA

Legal business name

FAIR OAKS RCF, LLC

Doing business as

Fair Oaks Care Centre

Practice address

1201 S Walnut St
Shenandoah, IA 51601-2176

Phone

(712) 246-2055

Fax

(712) 246-2099

NPI assigned

Mar 21, 2012

Last updated

Mar 21, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

IANE PROPERTIESAs reported in NPPES

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

Authorized official

Name

Mr. Richard T Mason

Title

Authorized Representative

Phone

(888) 391-2373

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fair Oaks Care Centre Doing business as

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1376818419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S WALNUT ST",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012176",
            "telephone_number": "712-246-2055",
            "fax_number": "712-246-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S WALNUT ST",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012176",
            "telephone_number": "712-246-2055",
            "fax_number": "712-246-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR OAKS RCF, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IANE PROPERTIES",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "888-391-2373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IA",
            "license": "730994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346434826",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fair Oaks Care Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Shenandoah, IA
• Providers in Shenandoah, IA by specialty
• Nursing Facility/Intermediate Care Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.