Jersey Ridge Place, L.L.C.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

S0079 Issued in IA

Legal business name

JERSEY RIDGE PLACE, L.L.C.

Practice address

5605 Jersey Ridge Rd
Davenport, IA 52807-3132

Phone

(563) 355-2027

Fax

(563) 441-9227

NPI assigned

Nov 30, 2007

Organization subpart

No

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

Authorized official

Name

Karen McCoy

Title

Director

Phone

(563) 355-2027

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1609058767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073132",
            "telephone_number": "563-355-2027",
            "fax_number": "563-441-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073132",
            "telephone_number": "563-355-2027",
            "fax_number": "563-441-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY RIDGE PLACE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "563-355-2027"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": "S0079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Jennings, DDS
• Jennie Sue Jensen, RN
• Kathy Jensen, LISW
• Jersey Ridge Chiro & Rehab
• Jersey Ridge Dental Associates
• Jestel Health Services, Inc.
• Jillyn Kaufman, PLC
• JMJ3 Heritage, L.L.C.
• Jmwellness PLLC
• Joann C Milani, PH.D. P.C

• Assisted Living Facility in Davenport, IA
• Providers in Davenport, IA by specialty
• Assisted Living Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.