Bettendorf Nursing Home Company

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

820880 Issued in IA

Legal business name

BETTENDORF NURSING HOME COMPANY

Practice address

2730 Crow Creek Rd
Bettendorf, IA 52722-2066

Phone

(563) 332-7463

Fax

(563) 332-3656

NPI assigned

Mar 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Donald L Chensvold

Title

Manager

Phone

(319) 362-8916

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bettendorf Health Care Center Doing business as

Locations

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1497714224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527220018",
            "telephone_number": "563-332-7463",
            "fax_number": "563-332-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 CROW CREEK RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222066",
            "telephone_number": "563-332-7463",
            "fax_number": "563-332-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTENDORF NURSING HOME COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "CHENSVOLD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "319-362-8916",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "820880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0809178",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "16D0387557",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bettendorf Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ashley Katherine Binks, MOT, OTR L
• Paul Ralph Black Jr., D.D.S.

• All providers in Bettendorf, IA
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.