Shenandoah Medical Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

730860 Issued in IA

Legal business name

SHENANDOAH MEDICAL CENTER

Practice address

1203 S Elm St
Shenandoah, IA 51601-2221

Phone

(712) 246-4627

Fax

(712) 246-7357

NPI assigned

Sep 23, 2005

Organization subpart

No

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

Authorized official

Name

Dennis Dewild

Title

Administrator

Phone

(712) 246-4627

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• ELM HEIGHTS CARE CENTER Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Shenandoah Medical Center

  • Rural Health Clinic/Center
  • Shenandoah, IA
  • NPI 1427300201

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470268800000",
    "number": "1609862887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PERSHING AVE",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012355",
            "telephone_number": "712-246-4627",
            "fax_number": "712-246-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 S ELM ST",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012221",
            "telephone_number": "712-246-4627",
            "fax_number": "712-246-7357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2016-08-04",
        "status": "A",
        "authorized_official_last_name": "DEWILD",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "712-246-4627"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IA",
            "license": "730860",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "730860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0806505",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELM HEIGHTS CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shenandoah Medical Center
• Shenandoah Medical Center
• Shenandoah Medical Center
• Shenandoah Medical Center
• Shenandoah Medical Center
• Shenandoah Medical Center
• Shenandoah Medical Center
• Shenandoah Memorial Hospital
• Shenandoah Memorial Hospital DME
• Shenandoan C.S.D.

• Skilled Nursing Facility in Shenandoah, IA
• Providers in Shenandoah, 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 Aug 4, 2016; 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.