Opco Sioux City, Ia, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

OPCO SIOUX CITY, IA, LLC

Practice address

6120 Morningside Ave
Sioux City, IA 51106-3943

Phone

(712) 276-3000

NPI assigned

Jan 12, 2021

Organization subpart

No

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

Authorized official

Name

Isaac Dole

Title

President/Ceo

Phone

(773) 645-9246

Specialties & licenses 1

Addresses

Other names 1

• Countryside Health Care Center Doing business as

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1902495112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 MORNINGSIDE AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063943",
            "telephone_number": "712-276-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 MORNINGSIDE AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063943",
            "telephone_number": "712-276-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPCO SIOUX CITY, IA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "DOLE",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-645-9246"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Countryside Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Countryside Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zackery Olson, DPT
• Nicholas Xavier Olund, PHARMD
• Dena Z Olwan, PHD
• Diana C Opara, RN
• Opco 19TH St. Sioux City, Ia, LLC
• Open Arms Psychological Services, LLC
• Opportunities Unlimited
• Opportunities Unlimited
• Opportunities Unlimited
• Opportunities Unlimited

• Skilled Nursing Facility in Sioux City, IA
• Providers in Sioux City, 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 Oct 29, 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.