NPIMap

Organization Active NPI

Iowa Jewish Senior Life Center

  • Nursing Facility/Intermediate Care Facility
  • Des Moines, IA
National Provider Identifier
1487807863
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
N-384 Issued in IA
Legal business name
IOWA JEWISH SENIOR LIFE CENTER
Practice address
900 Polk Blvd
Des Moines, IA 50312-2225
Phone
(515) 255-5433
Fax
(515) 277-8898
NPI assigned
Oct 29, 2008
Last updated
Oct 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Authorized official

Name
Marlene E. Wiese
Title
Accounting Manager
Phone
(515) 255-5433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X N-384 IA Primary

Addresses

Primary practice location

900 Polk Blvd
Des Moines, IA 50312-2225

Mailing address

900 Polk Blvd
Des Moines, IA 50312-2225
Phone (515) 255-5433

Other identifiers 1

IdentifierTypeStateIssuer
0802025MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Iowa Jewish Senior Life Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1487807863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 POLK BLVD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503122225",
            "telephone_number": "515-255-5433",
            "fax_number": "515-277-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 POLK BLVD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503122225",
            "telephone_number": "515-255-5433",
            "fax_number": "515-277-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA JEWISH SENIOR LIFE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "WIESE",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "515-255-5433"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IA",
            "license": "N-384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0802025",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.