Premier Estates 502, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

940127 Issued in IA

Legal business name

PREMIER ESTATES 502, LLC

Doing business as

Grandview Health Care Center

Practice address

508 2ND St NE
Dayton, IA 50530-7530

Phone

(515) 547-2288

Fax

(515) 547-2287

NPI assigned

Jan 11, 2016

Last updated

Jun 10, 2016By 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

Jamie Culp

Title

Controller

Phone

(941) 758-4745

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grandview Health Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972969681. Details of each certification follow.

• CCN 165196 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 165196

Legal name

PREMIER ESTATES 502, LLC

Doing business as

GRANDVIEW HEALTH CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 3, 1994

Last certification

Dec 5, 2024

Beds

40

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Dec 1, 2015 in FL

Enrollment address

508 2ND St NE
Dayton, IA 50530-7530

Listed as

Grandview Healthcare CenterCCN 165196 · All quality measures

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 3, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4034.0 residents per day on average

Penalties (3 years)

1Fines totaling $33,598

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Brian Whyms, DO

  • Internal Medicine Physician
  • Des Moines, IA
  • NPI 1821440066

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Premier Estates 507, LLC

  dba Lenox Care Center

  • Skilled Nursing Facility
  • Lenox, IA
  • NPI 1265898969

  Arboreta Health and Rehabilitation Centers, LLC, Arboreta Healthcare Consulting, LLC, Arboreta Healthcare, Inc, Greenside Healthcare Properties LLC, P&M Holding Group LLP

  CMS ownership
• Premier Estates of Kenesaw, LLC

  • Skilled Nursing Facility
  • Kenesaw, NE
  • NPI 1407233257

  Arboreta Health and Rehabilitation Centers, LLC, Arboreta Healthcare Consulting, LLC, Arboreta Healthcare, Inc

  CMS ownership
• Premier Estates of Pierce, LLC

  • Skilled Nursing Facility
  • Pierce, NE
  • NPI 1205213055

  Arboreta Health and Rehabilitation Centers, LLC, Arboreta Healthcare Consulting, LLC

  CMS ownership
• St Paul Elder Services, Inc

  • Skilled Nursing Facility
  • Kaukauna, WI
  • NPI 1093786543

  P&M Holding Group LLP

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Whyms, DO

  • Internal Medicine Physician
  • Des Moines, IA
  • NPI 1821440066
  NPD (past)

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1972969681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085509",
            "telephone_number": "941-758-4745",
            "fax_number": "941-751-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 2ND ST NE",
            "city": "DAYTON",
            "state": "IA",
            "postal_code": "505307530",
            "telephone_number": "515-547-2288",
            "fax_number": "515-547-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ESTATES 502, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "CULP",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "941-758-4745"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "940127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800180",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grandview Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hamilton County Public Hospital (Van Diest Medical Center Dayton Clinic)
• Shannon C Marso, PTA
• Antoinette Kathleen Martz, ARNP
• Opco Dayton, Ia, LLC (Grandview Health Care Center)
• Katelin J Peterson, RBT
• Pamela R. Wentworth, RN

• Skilled Nursing Facility in Dayton, IA
• Providers in Dayton, 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 Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.