NPIMap

Organization Active NPI

Waverley - Maple Manor, Inc.

  • Skilled Nursing Facility
  • Osage, IA
National Provider Identifier
1679564496
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
660171 Issued in IA
Legal business name
WAVERLEY - MAPLE MANOR, INC.
Practice address
830 S 5TH St
Osage, IA 50461-1919
Phone
(641) 732-5520
NPI assigned
Nov 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Mr. Chauncey R. Dunbar, CPA
Title
Secretary / Treasurer
Phone
(601) 956-1576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 660171 IA Primary

Addresses

Primary practice location

830 S 5TH St
Osage, IA 50461-1919

Mailing address

830 S 5TH St
Osage, IA 50461-1919
Phone (641) 732-5520

Other identifiers 1

IdentifierTypeStateIssuer
0807024MedicaidIA

Other names 1

  • Osage Rehabilitation and Health Care Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1679564496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S 5TH ST",
            "city": "OSAGE",
            "state": "IA",
            "postal_code": "504611919",
            "telephone_number": "641-732-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S 5TH ST",
            "city": "OSAGE",
            "state": "IA",
            "postal_code": "504611919",
            "telephone_number": "641-732-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLEY - MAPLE MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "DUNBAR",
        "authorized_official_first_name": "CHAUNCEY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "SECRETARY / TREASURER",
        "authorized_official_telephone_number": "601-956-1576",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "660171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0807024",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Osage Rehabilitation and Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osage, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.