Midwest Covenant Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

644002 Issued in NE

Legal business name

MIDWEST COVENANT HOME, INC.

Practice address

615 E 9TH St
Stromsburg, NE 68666-4053

Phone

(402) 764-2711

NPI assigned

Jul 6, 2011

Organization subpart

Yes

Parent organization

SKILLED NURSING FACILITYAs reported in NPPES

Name

Mr. Christoper M Young

Title

Administrator

Phone

(402) 764-2711

Part of

Midwest Covenant Home Inc

• Midwest Covenant Home OTHS Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 6, 2011.

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1962799320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E 9TH ST",
            "address_2": "P O BOX 367",
            "city": "STROMSBURG",
            "state": "NE",
            "postal_code": "686664053",
            "telephone_number": "402-764-2711",
            "fax_number": "402-764-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E 9TH ST",
            "city": "STROMSBURG",
            "state": "NE",
            "postal_code": "686664053",
            "telephone_number": "402-764-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST COVENANT HOME, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SKILLED NURSING FACILITY",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CHRISTOPER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-764-2711",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "644002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Covenant Home OTHS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brent Jameson, MD
• David Bryce Jameson, MD
• James Lawrence Kappers, PLMHP
• Celeste McCoy
• Midwest Covenant Home, Inc.
• Hyde Patience, M.S. ED., CCC-SLP
• Peterson Chiropractic and Wellness LLC
• Connor Neal Peterson, DC
• Prairie Creek Family Medicine LLC
• Tanya Michelle Randolph-Elgin, PSY.D.

• All providers in Stromsburg, NE
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.