Rock of Ages Home Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

8021B Issued in ND

Legal business name

ROCK OF AGES HOME INC

Practice address

1315 4TH St NE
Jamestown, ND 58401-3726

Phone

(701) 252-9292

Fax

(701) 252-0417

NPI assigned

Nov 7, 2006

Last updated

Aug 22, 2020By 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

Tim M Exner

Title

Administrator Owner

Phone

(701) 252-9292

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609945005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 4TH ST NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013726",
            "telephone_number": "701-252-9292",
            "fax_number": "701-252-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 4TH ST NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013726",
            "telephone_number": "701-252-9292",
            "fax_number": "701-252-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK OF AGES HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EXNER",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR OWNER",
        "authorized_official_telephone_number": "701-252-9292"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ND",
            "license": "8021B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30716",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Rittenbach, NP
• Sandra L Rivinius, LAC
• Tara Jeanine Roaldson
• Danielle Robbins, PSY.D.
• Maria Diana E. Robles, M.D.
• Taylor Roddie
• Shawna Leigh Rode, MS, OTRL
• Oscar Evan Rodriguez
• Tanesha Roehrich, COTA/L
• Stacy Roers Irmen, MD

• Assisted Living Facility in Jamestown, ND
• Providers in Jamestown, ND by specialty
• Assisted Living Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.