Maplewood Manor Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

540351 Issued in IA

Legal business name

MAPLEWOOD MANOR INC

Practice address

204 N Keokuk Washington Rd
Keota, IA 52248-9496

Phone

(641) 636-3400

Fax

(641) 636-3150

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Mary L Runde

Title

President

Phone

(641) 636-3400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maplewood Manor Doing business as

Locations

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1922095975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N KEOKUK WASHINGTON RD",
            "city": "KEOTA",
            "state": "IA",
            "postal_code": "522489496",
            "telephone_number": "641-636-3400",
            "fax_number": "641-636-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N KEOKUK WASHINGTON RD",
            "city": "KEOTA",
            "state": "IA",
            "postal_code": "522489496",
            "telephone_number": "641-636-3400",
            "fax_number": "641-636-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "RUNDE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "641-636-3400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "540351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0802512",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maplewood Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keota Community School District
• Keota Family Practice
• Keota Health Care Center LLC
• Breena Luers, PT, MHH, DPT
• Mariah Cheyenne Lyle, DC
• Jackie K Morgan, ARNP
• Opco Keota, Ia, LLC
• Abby Purkeypile, RN,MSN
• Shawna Sieren
• Jeannie Marie Verstraete, PTA

• All providers in Keota, IA
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.