QHC Fort Dodge Villa LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0800053 Issued in IA

Legal business name

QHC FORT DODGE VILLA LLC

Doing business as

Fort Dodge Villa Care Center

Practice address

2721 10TH Ave N
Fort Dodge, IA 50501-2834

Phone

(515) 576-7525

Fax

(515) 955-7528

NPI assigned

Aug 28, 2005

Last updated

Dec 15, 2014By 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

Jerry William Voyna, CPA

Title

Owner

Phone

(515) 276-3656

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fort Dodge Villa Care Center Doing business as

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

{
    "created_epoch": "1125187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418601600000",
    "number": "1942293667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 HICKMAN RD",
            "address_2": "SUITE 15",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503254311",
            "telephone_number": "515-276-3656",
            "fax_number": "515-276-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 10TH AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505012834",
            "telephone_number": "515-576-7525",
            "fax_number": "515-955-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QHC FORT DODGE VILLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-28",
        "last_updated": "2014-12-15",
        "status": "A",
        "authorized_official_last_name": "VOYNA",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-276-3656",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "0800053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800053",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Dodge Villa Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Fort Dodge, IA
• Providers in Fort Dodge, 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 Dec 15, 2014; 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.