Signature Properties of Sutherland LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

710198 Issued in IA

Legal business name

SIGNATURE PROPERTIES OF SUTHERLAND LLC

Doing business as

Sutherland Care Center

Practice address

506 E 4TH St
Sutherland, IA 51058

Phone

(712) 446-3857

Fax

(712) 446-2633

NPI assigned

Nov 15, 2005

Last updated

Feb 8, 2012By 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

Mr. Bruce Mehlhop

Title

Managing Member

Phone

(515) 727-1768

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sutherland Care Center Doing business as

Locations

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1942282181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 BIRCHWOOD CT",
            "address_2": "SUITE A, PO BOX 917",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501310917",
            "telephone_number": "515-727-1770",
            "fax_number": "515-727-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E 4TH ST",
            "city": "SUTHERLAND",
            "state": "IA",
            "postal_code": "51058",
            "telephone_number": "712-446-3857",
            "fax_number": "712-446-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE PROPERTIES OF SUTHERLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "MEHLHOP",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "515-727-1768",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "710198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805077",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutherland Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Fiddelke, ARNP
• Anne Hellmann, CNA, CMA
• Matthew D Johnson, RPT
• Diane Lee, OTA
• Pearl Valley Rehabilitation and Nursing at Sutherland, LLC
• Sioux Valley Memorial Hospital Association (Sutherland Medical Clinic)
• Sutherland Opco LLC (Sutherland Community Care Center)
• Sutherland Opco LLC (Sutherland Community Care Center)
• Sutherland SNF Operator LLC

• Skilled Nursing Facility in Sutherland, IA
• Providers in Sutherland, 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 Feb 8, 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.