Active NPI
St Declan Home Care
- Home Health Agency
- Marion, IA
National Provider Identifier
1770360703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- ST DECLAN HOME CARE
- Practice address
- 6070 Woodbridge CRST
Marion, IA 52302-9551 - Phone
- (515) 661-0262
- NPI assigned
- Sep 13, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anna Shudzeka
- Title
- Ceo
- Phone
- (515) 661-0262
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | |||
| Home Health Agency | 251E00000X | Primary | ||
| Nursing Care Agency | 251J00000X | |||
| In Home Supportive Care Agency | 253Z00000X |
Addresses
Primary practice location
6070 Woodbridge CRST
Marion, IA 52302-9551
Mailing address
6070 Woodbridge CRST
Marion, IA 52302-9551
Phone (515) 661-0262
National Provider Directory
National Provider Directory- Tax ID family
- St Declan Home Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- In Home Supportive Care Agency
- Marion, IA
- NPI 1366209165
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Cedar Rapids, IA
- NPI 1730514415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694563200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1704240000000",
"number": "1770360703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6070 WOODBRIDGE CRST",
"city": "MARION",
"state": "IA",
"postal_code": "523029551",
"telephone_number": "515-661-0262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6070 WOODBRIDGE CRST",
"city": "MARION",
"state": "IA",
"postal_code": "523029551",
"telephone_number": "515-661-0262"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST DECLAN HOME CARE",
"organizational_subpart": "NO",
"enumeration_date": "2023-09-13",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A",
"authorized_official_last_name": "SHUDZEKA",
"authorized_official_first_name": "ANNA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "515-661-0262"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marion, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.