NPIMap

Organization Active NPI

Shirlees Retirement Home

  • Nursing Facility/Intermediate Care Facility
  • Indianola, IA
National Provider Identifier
1497921464
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
251J00000X Issued in IA
Legal business name
SHIRLEES RETIREMENT HOME
Practice address
1302 E 2ND Ave
Indianola, IA 50125-2804
Phone
(515) 961-6673
Fax
(515) 961-2737
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Ms. Shirley Udene Baker
Title
Administrator
Phone
(515) 961-6673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 251J00000X IA Primary

Addresses

Primary practice location

1302 E 2ND Ave
Indianola, IA 50125-2804

Mailing address

1302 E 2ND Ave
Indianola, IA 50125-2804
Phone (515) 961-6673

Other identifiers 1

IdentifierTypeStateIssuer
0891481MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Shirlees Retirement Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1497921464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 E 2ND AVE",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501252804",
            "telephone_number": "515-961-6673",
            "fax_number": "515-961-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 E 2ND AVE",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501252804",
            "telephone_number": "515-961-6673",
            "fax_number": "515-961-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIRLEES RETIREMENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "UDENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "515-961-6673",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IA",
            "license": "251J00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0891481",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.