Plymouth Manor Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

750234 Issued in IA

Legal business name

PLYMOUTH MANOR INC

Doing business as

Plymouth Manor Care Center

Practice address

954 7TH Ave SE
Le Mars, IA 51031-2602

Phone

(712) 546-7831

Fax

(712) 546-7990

NPI assigned

Jan 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Richard Amlie

Title

President

Phone

(319) 290-1490

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Plymouth Manor Care Center Doing business as

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1669450615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 7TH AVE SE",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510312602",
            "telephone_number": "712-546-7831",
            "fax_number": "712-546-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 7TH AVE SE",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510312602",
            "telephone_number": "712-546-7831",
            "fax_number": "712-546-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "AMLIE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-290-1490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "750234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0803288",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plymouth Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jay Vincent Penning, DC
• Darci Robin Philipp Grave
• Plains Area Mental Health, Inc.
• Plains Area Mental Health, Inc.
• Plymouth Life, Inc. (Pride Group, Inc.)
• Ashley Powell, D.O.
• Lyndsi Price, PHARMD
• Cassandra Prieksat, CADC TEMP
• Diana Kay Rann, RN
• Jordan Ann Reed, MOT, OTR/L

• Skilled Nursing Facility in Le Mars, IA
• Providers in Le Mars, 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 Mar 27, 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.