Sunny Knoll Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

130168 Issued in IA

Legal business name

SUNNY KNOLL CARE CENTER, LLC

Practice address

135 Warner St
Rockwell City, IA 50579-1722

Phone

(712) 297-8918

Fax

(712) 297-5535

NPI assigned

Apr 6, 2006

Last updated

Oct 4, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gregory S Bench

Title

Authorized Representative

Phone

(941) 758-4745

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sunny Knoll Care Center, LLC Former legal business name

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507075200000",
    "number": "1508828120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085509",
            "telephone_number": "941-758-4745",
            "fax_number": "941-751-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WARNER ST",
            "city": "ROCKWELL CITY",
            "state": "IA",
            "postal_code": "505791722",
            "telephone_number": "712-297-8918",
            "fax_number": "712-297-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNY KNOLL CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2017-10-04",
        "status": "A",
        "authorized_official_last_name": "BENCH",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "941-758-4745",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "130168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0803858",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800076",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunny Knoll Care Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Skilled Nursing Facility in Rockwell City, IA
• Providers in Rockwell City, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.