Ipswich SD Skilled Nursing Facility LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

IPSWICH SD SKILLED NURSING FACILITY LLC

Doing business as

Avantara Ipswich

Practice address

617 Bloemendaal Drive
Ipswich, SD 57451

Phone

(605) 426-6622

Fax

(605) 426-6565

NPI assigned

May 13, 2019

Last updated

May 13, 2019By 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

Menachem Shabat

Title

Coo/Principal

Phone

(847) 679-9797

Specialties & licenses 1

Addresses

Other names 1

• Avantara Ipswich Doing business as

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1902462211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "847-679-9797",
            "fax_number": "847-679-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 BLOEMENDAAL DRIVE",
            "city": "IPSWICH",
            "state": "SD",
            "postal_code": "57451",
            "telephone_number": "605-426-6622",
            "fax_number": "605-426-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPSWICH SD SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "SHABAT",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "COO/PRINCIPAL",
        "authorized_official_telephone_number": "847-679-9797"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avantara Ipswich",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crissman Drug
• Eureka Pharmacy & Gift Shoppe Inc (Vilas Pharmacy)
• Lacey Lynn Galbraith, PT
• Ipswich Care and Rehabilitation Center LLC (Ipswich Care and Rehabilitation Center)
• Ipswich Public School District #22-6
• Melissa Ann Jorgenson, PTA
• Kadlec (Active Care Chiropractic)
• Nathan Kadlec, DC
• Mary M Ludwig
• Sanford Health Network (Sanford Ipswich Clinic)

• Skilled Nursing Facility in Ipswich, SD
• Providers in Ipswich, SD by specialty
• Skilled Nursing Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.