NPIMap

Organization Active NPI

Childserve Homes Inc.

Doing business as ChildServe Ankeny Duplex

  • Intellectual Disabilities Intermediate Care Facility
  • Ankeny, IA
National Provider Identifier
1861534695
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
771152 Issued in IA
Legal business name
CHILDSERVE HOMES INC.
Doing business as
ChildServe Ankeny Duplex
Practice address
2164 SW 35TH St
Ankeny, IA 50023-5901
Phone
(515) 289-2513
Fax
(515) 289-1410
NPI assigned
Feb 12, 2007
Organization subpart
Yes
Parent organization
CHILDSERVE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Authorized official

Name
Rodney Wildrick
Title
Director of Accounting
Phone
(515) 727-1468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 771152 IA Primary

Addresses

Primary practice location

2164 SW 35TH St
Ankeny, IA 50023-5901

Mailing address

PO Box 707
Johnston, IA 50131-0707
Phone (515) 727-8750

Other identifiers 1

IdentifierTypeStateIssuer
0882126MedicaidIA

Other names 1

  • ChildServe Ankeny Duplex Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Childserve Homes Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1861534695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501310707",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2164 SW 35TH ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500235901",
            "telephone_number": "515-289-2513",
            "fax_number": "515-289-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDSERVE HOMES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDSERVE INC.",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "WILDRICK",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTING",
        "authorized_official_telephone_number": "515-727-1468"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IA",
            "license": "771152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0882126",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChildServe Ankeny Duplex",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.