NPIMap

Organization Active NPI

Windsor Manor

  • Assisted Living Facility
  • Vinton, IA
National Provider Identifier
1467674630
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
WINDSOR MANOR
Practice address
1807 W 5TH Street
Vinton, IA 52349
Phone
(319) 472-2060
NPI assigned
May 3, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Bethany Clemenson
Title
RN Manager
Phone
(319) 472-2060

Specialties & licenses 1

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

Addresses

Primary practice location

1807 W 5TH Street
Vinton, IA 52349

Mailing address

1807 W 5TH Street
Vinton, IA 52349
Phone (319) 472-2060

Other identifiers 1

IdentifierTypeStateIssuer
0749945MedicaidIA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1063684Windsor Manor Vinton1807 West 5TH Street, Vinton, IA 52349Certificate of waiverJan 18, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467674630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 W 5TH STREET",
            "city": "VINTON",
            "state": "IA",
            "postal_code": "52349",
            "telephone_number": "319-472-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W 5TH STREET",
            "city": "VINTON",
            "state": "IA",
            "postal_code": "52349",
            "telephone_number": "319-472-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDSOR MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CLEMENSON",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "RN MANAGER",
        "authorized_official_telephone_number": "319-472-2060",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0749945",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.