Organization Active NPI

St Declan Home Care

  • Home Health Agency
  • Marion, IA
National Provider Identifier
1770360703
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Jan 3, 2024

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

Authorized official

Name
Anna ShudzekaNPI 1730514415
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)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 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 Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.