Bettendorf Healthcare Management LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

820880 Issued in IA

Legal business name

BETTENDORF HEALTHCARE MANAGEMENT LLC

Practice address

2730 Crow Creek Rd
Bettendorf, IA 52722-2066

Phone

(563) 332-7463

Fax

(563) 332-7464

NPI assigned

Nov 2, 2012

Organization subpart

No

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

Authorized official

Name

Judah Bienstock

Title

Managing Member

Phone

(314) 812-2550

Specialties & licenses 1

Addresses

Other names 1

• Bettendorf Health Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1699029322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 CROW CREEK RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222066",
            "telephone_number": "563-332-7463",
            "fax_number": "563-332-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 CROW CREEK RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222066",
            "telephone_number": "563-332-7463",
            "fax_number": "563-332-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTENDORF HEALTHCARE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "BIENSTOCK",
        "authorized_official_first_name": "JUDAH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "314-812-2550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "820880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bettendorf Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Bettendorf, IA
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.