Blue Care Opco Humboldt - South, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

BLUE CARE OPCO HUMBOLDT - SOUTH, LLC

Practice address

800 13TH St S
Humboldt, IA 50548-2439

Phone

(732) 637-9191

NPI assigned

May 2, 2022

Organization subpart

No

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

Authorized official

Name

Shmeul Haikins

Title

Owner

Phone

(732) 637-9191

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1477298602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 AIRPORT RD # S206",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087017034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 13TH ST S",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505482439",
            "telephone_number": "732-637-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CARE OPCO HUMBOLDT - SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "HAIKINS",
        "authorized_official_first_name": "SHMEUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-637-9191"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 1St Avenue Chiropractic, P.C.
• Riley Evan Anderson, PT, DPT, ATC
• Rebecca Knox Aquino, PTA
• Keri Ann Benjamin, ARNP
• Blue Care Opco Humboldt - North, LLC
• Sherry Bulten, MD
• Mackenzie Lynn Carlson, ARNP
• Lindsay Charon, PHARMD
• Jimmy L Chorpening
• Mark Cirks, DC

• Nursing Facility/Intermediate Care Facility in Humboldt, IA
• Providers in Humboldt, 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 May 2, 2022; 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.