NPIMap

Organization Active NPI

Regency Park Nursing and Rehabilitation Center of Jefferon

  • Skilled Nursing Facility
  • Jefferson, IA
National Provider Identifier
1699824979
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
370034 Issued in IA
Legal business name
REGENCY PARK NURSING AND REHABILITATION CENTER OF JEFFERON
Practice address
100 Ram Dr
Jefferson, IA 50129-2728
Phone
(515) 386-4107
Fax
(515) 386-2347
NPI assigned
Jan 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Matthew Allen Carpenter, NHA
Title
Administrator
Phone
(515) 386-4107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 370034 IA Primary

Addresses

Primary practice location

100 Ram Dr
Jefferson, IA 50129-2728

Mailing address

100 Ram Dr
Jefferson, IA 50129-2728
Phone (515) 386-4107

National Provider Directory

National Provider Directory
Tax ID family
Centers for Long Term Care of Iowa6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699824979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RAM DR",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501292728",
            "telephone_number": "515-386-4107",
            "fax_number": "515-386-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RAM DR",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501292728",
            "telephone_number": "515-386-4107",
            "fax_number": "515-386-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY PARK NURSING AND REHABILITATION CENTER OF JEFFERON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "515-386-4107",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "370034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.