Abcm Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

850819 Issued in IA

Legal business name

ABCM CORPORATION

Doing business as

Rolling Green Village

Practice address

100 6TH St
Nevada, IA 50201-2502

Phone

(515) 382-6556

Fax

(515) 382-1425

NPI assigned

Aug 15, 2005

Last updated

Oct 19, 2010By 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

Timothy Roberts

Title

Cfo

Phone

(641) 456-5636

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Rolling Green Village Doing business as

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1932101482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 4TH ST NE",
            "city": "HAMPTON",
            "state": "IA",
            "postal_code": "504411104",
            "telephone_number": "641-456-5636",
            "fax_number": "641-456-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 6TH ST",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502012502",
            "telephone_number": "515-382-6556",
            "fax_number": "515-382-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABCM CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "641-456-5636"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "850819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "65361",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0802959",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rolling Green Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sara Anderson, OT
• Damiun Bassandeh, CRNA
• Jessica Bell, PTA
• Erin Bergquist, PHD,MPH,RD,LD
• Pierre Rene' Bernard, DO

• Skilled Nursing Facility in Nevada, IA
• Providers in Nevada, 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 19, 2010; 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.