Premier Estates of Muscatine, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PREMIER ESTATES OF MUSCATINE, LLC

Doing business as

Premier Estates of Muscatine

Practice address

3440 Mulberry Ave
Muscatine, IA 52761-2323

Phone

(563) 263-2194

Fax

(563) 263-2253

NPI assigned

Nov 10, 2006

Last updated

Jun 18, 2014By 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

Gregory S Bench

Title

Ceo

Phone

(888) 391-2373

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Premier Estates of Muscatine Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1427129899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 MULBERRY AVE",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527612323",
            "telephone_number": "563-263-2194",
            "fax_number": "563-263-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 MULBERRY AVE",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527612323",
            "telephone_number": "563-263-2194",
            "fax_number": "563-263-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ESTATES OF MUSCATINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "BENCH",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-391-2373"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0809913",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800108",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Estates of Muscatine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• PH Muscatine, LLC (Platinum Health Care of Muscatine)
• Karen Pierce, PA-C
• Benjamin J Pohl, PA-C
• Payton L Pool, LMSW
• Austin Porter, D.C.
• Desiree R Price, DNP, AGNP-C
• Anna Prier, OD
• Vickie Lynn Proctor, CMA
• Brian William Proffitt, DDS
• Quality Cobbler Inc

• Skilled Nursing Facility in Muscatine, IA
• Providers in Muscatine, 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 Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.