Crystal Properties Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

910845 Issued in IA

Legal business name

CRYSTAL PROPERTIES INC

Doing business as

Regency Care Center

Practice address

815 High Rd
Norwalk, IA 50211-1462

Phone

(515) 223-0758

Fax

(515) 223-9499

NPI assigned

Oct 25, 2006

Last updated

Dec 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randy Lange

Title

Owner

Phone

(515) 223-0758

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Regency Care Center Doing business as

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1841374881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 HIGH RD",
            "city": "NORWALK",
            "state": "IA",
            "postal_code": "502111462",
            "telephone_number": "515-223-0758",
            "fax_number": "515-223-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HIGH RD",
            "city": "NORWALK",
            "state": "IA",
            "postal_code": "502111462",
            "telephone_number": "515-223-0758",
            "fax_number": "515-223-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL PROPERTIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "LANGE",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-223-0758"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": "S0232",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "910845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049533",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805440",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "65399",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tina Conyers
• Kelly Cook, AU.D.
• Alexis Marie Cooley, OT
• Amy C Crane, PAC
• Paige Elise Crosby, OTR/L
• Emilee Elizabeth Danner-Borneman
• Siobhan Decker
• Nina Demuth
• Lori J Denton, PA
• Brent James Derocher, DC

• Skilled Nursing Facility in Norwalk, IA
• Providers in Norwalk, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.