Countryside Health Investors LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COUNTRYSIDE HEALTH INVESTORS LLC

Doing business as

Countryside Health Care Center

Practice address

6120 Morningside Ave
Sioux City, IA 51106-3943

Phone

(712) 276-3000

Fax

(712) 266-2167

NPI assigned

Oct 26, 2015

Organization subpart

No

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

Authorized official

Name

Michael Sorrells

Title

Member

Phone

(812) 525-1114

Specialties & licenses 1

Addresses

Other names 1

• Countryside Health Care Center Doing business as

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1649642976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 MORNINGSIDE AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063943",
            "telephone_number": "712-276-3000",
            "fax_number": "712-266-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 MORNINGSIDE AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063943",
            "telephone_number": "712-276-3000",
            "fax_number": "712-266-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE HEALTH INVESTORS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "SORRELLS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "812-525-1114"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Countryside Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Copperstone Development
• Copperstone Development
• Teri Marie Copple, LMHC
• Counseling and Support Services 1 Inc
• Counseling and Support Services Inc
• Countryside Nursing and Rehabilitation Center, LLC
• Countryside Retirement Home of Sioux City, Iowa (Countryside Retirement Home, Inc.)
• Kali Renae Covey
• Kylie J Cowdin, M.D.
• Jody Cox, CADC

• Skilled Nursing Facility in Sioux City, IA
• Providers in Sioux City, 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 Oct 26, 2015; 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.