Makee Manor Inc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

030709 Issued in IA

Legal business name

MAKEE MANOR INC

Practice address

877 Highway 9
Waukon, IA 52172-7757

Phone

(563) 568-4266

Fax

(563) 568-6986

NPI assigned

Feb 13, 2007

Last updated

Aug 22, 2020By 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

Jan Ellingson

Title

Administrator

Phone

(563) 568-4266

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861534265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 HIGHWAY 9",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521727757",
            "telephone_number": "563-568-4266",
            "fax_number": "563-568-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 HIGHWAY 9",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521727757",
            "telephone_number": "563-568-4266",
            "fax_number": "563-568-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKEE MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLINGSON",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "563-568-4266"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "IA",
            "license": "030709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0746933",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0895748",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0233387",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0450676",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Deering
• Mason Lee Kerian
• Andrea Michele Krogman, APNP
• William Francis Loebig, CRNA
• Rose Marie Magner, RD, LD
• Katy Maureen Maker, ARNP, CNM
• Heather McDaniel, MA
• Dennis Clarence Montet, PT
• Jennifer Ann Moose, CNA
• Mosaic

• Custodial Care Facility in Waukon, IA
• Providers in Waukon, IA by specialty
• Custodial Care Facility in Iowa

• 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.