Five Star Quality Care Ia LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

730816 Issued in IA

Legal business name

FIVE STAR QUALITY CARE IA LLC

Doing business as

Westridge Quality Care & Rehab

Practice address

600 Manor Dr
Clarinda, IA 51632-2444

Phone

(712) 542-5161

Fax

(712) 542-3430

NPI assigned

May 26, 2006

Organization subpart

Yes

Parent organization

FIVE STAR QUALITY CARE IA LLCAs reported in NPPES

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

Authorized official

Name

Katherine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Westridge Quality Care & Rehab Doing business as

Part of

Five Star Quality Care Ia LLC

Locations

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1518913086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MANOR DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322444",
            "telephone_number": "712-542-5161",
            "fax_number": "712-542-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MANOR DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322444",
            "telephone_number": "712-542-5161",
            "fax_number": "712-542-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR QUALITY CARE IA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR QUALITY CARE IA LLC",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "730816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805374",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westridge Quality Care & Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Westridge Quality Care & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Clarinda, IA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.