Countryside Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COUNTRYSIDE HOME

Practice address

703 N Main St
Madison, NE 68748-6009

Phone

(402) 454-3373

Fax

(402) 454-6509

NPI assigned

Dec 13, 2005

Last updated

Jul 21, 2022By 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

Mrs. Linda Anderson, ADMINISTRATOR

Title

Administrator

Phone

(402) 454-3373

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• City of Madison

  dba Madison Fire & Rescue Sqaud

  • Ambulance
  • Madison, NE
  • NPI 1912084641

  Member Of

  NPD member

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1902881022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N MAIN ST",
            "city": "MADISON",
            "state": "NE",
            "postal_code": "687486009",
            "telephone_number": "402-454-3373",
            "fax_number": "402-454-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N MAIN ST",
            "city": "MADISON",
            "state": "NE",
            "postal_code": "687486009",
            "telephone_number": "402-454-3373",
            "fax_number": "402-454-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-454-3373",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0637150001",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leann Kay Borgmeyer
• Jennifer Bowers
• Gary N Bring, DDS
• Pow Ta Chou
• City of Madison (Madison Fire & Rescue Sqaud)
• Mariah Delmont, PHYSICAL THERAPIST
• Dianette Espitia
• Anahi Fuentes
• Yuridia Gonzalez
• Catherine Ann Helvie

• Skilled Nursing Facility in Madison, NE
• Providers in Madison, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.