Fay Wookey Memorial, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

11038 Issued in SD

Legal business name

FAY WOOKEY MEMORIAL, INC.

Practice address

700 N Smith St
Clark, SD 57225-1120

Phone

(605) 532-5799

Fax

(605) 532-1320

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Gayle Donette Wookey

Title

Administrator

Phone

(605) 532-5799

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fay Wookey Memorial Assisted Living Center Doing business as

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720143316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N SMITH ST",
            "city": "CLARK",
            "state": "SD",
            "postal_code": "572251120",
            "telephone_number": "605-532-5799",
            "fax_number": "605-532-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N SMITH ST",
            "city": "CLARK",
            "state": "SD",
            "postal_code": "572251120",
            "telephone_number": "605-532-5799",
            "fax_number": "605-532-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAY WOOKEY MEMORIAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOOKEY",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "DONETTE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-532-5799",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "11038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9570180",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fay Wookey Memorial Assisted Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Clark, SD
• Assisted Living Facility in South Dakota

• 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.
• 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.