Rose Vista Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N-306 Issued in IA

Legal business name

ROSE VISTA HOME INC

Practice address

1109 Normal St
Woodbine, IA 51579-1091

Phone

(712) 647-2010

Fax

(712) 647-3235

NPI assigned

Sep 26, 2005

Last updated

Oct 10, 2011By 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. Jason Sherer

Title

Asst. Administrator

Phone

(712) 647-2010

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1972599876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 NORMAL ST",
            "address_2": "P.O. BOX 6",
            "city": "WOODBINE",
            "state": "IA",
            "postal_code": "515791091",
            "telephone_number": "712-647-2010",
            "fax_number": "712-647-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 NORMAL ST",
            "city": "WOODBINE",
            "state": "IA",
            "postal_code": "515791091",
            "telephone_number": "712-647-2010",
            "fax_number": "712-647-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE VISTA HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "SHERER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "ASST. ADMINISTRATOR",
        "authorized_official_telephone_number": "712-647-2010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "N-306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0803510",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.