Active NPI
Keystone Nursing Care Center Inc
- Skilled Nursing Facility
- Keystone, IA
National Provider Identifier
1922091552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 160604
- Legal business name
- KEYSTONE NURSING CARE CENTER INC
- Practice address
- 250 5TH St E
Keystone, IA 52249-9521 - Phone
- (319) 442-3234
- Fax
- (319) 442-3550
- NPI assigned
- Aug 30, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Tracy Lynn Hanson, RN BSN ADMINISTRATOR
- Title
- Administrator
- Phone
- (319) 442-3234
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | N263 | IA | |
| Skilled Nursing Facility | 314000000X | 160604 | IA | Primary |
Addresses
Primary practice location
250 5TH St E
Keystone, IA 52249-9521
Mailing address
250 5TH St E
Keystone, IA 52249-9521
Phone (319) 442-3234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0802140 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110617000544 | IA | Part A Provider - Skilled Nursing Facility | 8628256898 | Practice locations: Keystone, IA |
Skilled nursing facility certification: CCN 165604
- Legal name
- KEYSTONE NURSING CARE CENTER INC
- Doing business as
- KEYSTONE NURSING CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 17, 2012
- Last certification
- Sep 19, 2024
- Beds
- 55
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Enrollment address
- 250 5TH St
Keystone, IA 52249-9521 - Nursing home name
- KEYSTONE NURSING CARE CENTER INC
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Keystone Nursing Care Center INC
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 17, 2012
- Medicare certification status
- Active
- Certified beds
- 55
National Provider Directory
National Provider Directory- Tax ID family
- Keystone Nursing Care Center Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Keystone, IA
- NPI 1881173193
-
- Home Health Agency
- Keystone, IA
- NPI 1770944167
-
- Home Health Agency
- Keystone, IA
- NPI 1003246000
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Brian W Meeker | Corporate Director | Mar 16, 2012 | 100% |
| Operational/Managerial Control | Mar 16, 2012 | 100% | |
| Adp of the SNF | Apr 2, 2025 | ||
| Tracy L Bruns | Corporate Director | Mar 16, 2012 | 100% |
| Operational/Managerial Control | Mar 16, 2012 | ||
| Managing Control - Governing Body | Mar 6, 2012 | ||
| Adp of the SNF | Mar 26, 2012 | ||
| Direct Ownership Interest | Mar 26, 2012 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Vinton, IA
- NPI 1326023391
Adp of the SNF, Corporate Director, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1536624000000",
"number": "1922091552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 5TH ST E",
"city": "KEYSTONE",
"state": "IA",
"postal_code": "522499521",
"telephone_number": "319-442-3234",
"fax_number": "319-442-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 5TH ST E",
"city": "KEYSTONE",
"state": "IA",
"postal_code": "522499521",
"telephone_number": "319-442-3234",
"fax_number": "319-442-3550"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KEYSTONE NURSING CARE CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-30",
"last_updated": "2018-09-11",
"status": "A",
"authorized_official_last_name": "HANSON",
"authorized_official_first_name": "TRACY",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "319-442-3234",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN BSN ADMINISTRATOR"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "IA",
"license": "N263",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IA",
"license": "160604",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0802140",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Keystone, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.