Signature Properties of Lake Park, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

300598 Issued in IA

Legal business name

SIGNATURE PROPERTIES OF LAKE PARK, LLC

Practice address

1304 South Market
Lake Park, IA 51347-1060

Phone

(712) 832-3691

Fax

(712) 832-9548

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Bruce H. Mehlhop, MA

Title

Managing Member

Phone

(515) 727-1770

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lake Park Care Center Doing business as

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1568444792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 SOUTH MARKET",
            "city": "LAKE PARK",
            "state": "IA",
            "postal_code": "513471060",
            "telephone_number": "712-832-3691",
            "fax_number": "712-832-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 SOUTH MARKET",
            "city": "LAKE PARK",
            "state": "IA",
            "postal_code": "513471060",
            "telephone_number": "712-832-3691",
            "fax_number": "712-832-9548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE PROPERTIES OF LAKE PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "MEHLHOP",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "515-727-1770",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "300598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0809731",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Park Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Niemeier Spine & Sports Chiropractic PLC
• Billi Niemeier, FNP
• Chad Michael Niemeier, D.C.
• Pearl Valley Rehabilitation and Nursing at Lake Park, LLC
• Sanford Health Network
• Sioux Valley Regional Health Services
• Elizabeth Stokke, FNP-C
• Kayla Updike, D.C.

• Skilled Nursing Facility in Lake Park, IA
• Providers in Lake Park, 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 Jan 20, 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.