Scottish Rite Park, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

770155 Issued in IA

Legal business name

SCOTTISH RITE PARK, INC.

Practice address

2909 Woodland Ave.
Des Moines, IA 50312

Phone

(515) 274-4614

Fax

(515) 274-6049

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark William Allen

Title

President

Phone

(515) 202-2010

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Skilled nursing facility certification: CCN 165593

Legal name

SCOTTISH RITE PARK INC

Doing business as

SCOTTISH RITE PARK HEALTH CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 22, 2009

Last certification

Jul 18, 2024

Beds

51

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 28, 1969 in IA

Enrollment address

2909 Woodland Ave
Des Moines, IA 50312-3885

Nursing home name

SCOTTISH RITE PARK INC

Listed as

Scottish Rite Park IncCCN 165593 · All quality measures

Overall star rating

5 of 5

Health inspections

3 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

May 22, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5132.0 residents per day on average

Penalties (3 years)

5Fines totaling $56,493

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Michael P O'Conner, DO

  • Internal Medicine Physician
  • Des Moines, IA
  • NPI 1396724167

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Michael P O'Conner, DO

  • Internal Medicine Physician
  • Des Moines, IA
  • NPI 1396724167

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252022400000",
    "number": "1679527840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 WOODLAND AVE.",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50312",
            "telephone_number": "515-274-4614",
            "fax_number": "515-274-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 WOODLAND AVE.",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50312",
            "telephone_number": "515-274-4614",
            "fax_number": "515-274-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTISH RITE PARK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2009-09-04",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-202-2010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IA",
            "license": "770155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "16D0912082",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA LICENSE #",
            "identifier": "770155",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800022",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abbie Nichole Scott, RD, LD
• Anna Scott
• David E Scott, O.D.
• Eddie Lee Scott III, PHD
• Katherine L Scott, DNP, CPNP-PC
• Penny Denise Scroggins
• Richard Kent Scupham, MD
• Rebecca S Seabrooke, LMHCT
• Gregory John Sealock X
• Scott Seaman, M.D.

• Nursing Facility/Intermediate Care Facility in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Nursing Facility/Intermediate Care Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.