CCRC OF GRIMES, LLC (NPI# 1013200914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013200914 |
| Entity Type | Organization |
| Organization Name | CCRC OF GRIMES, LLC |
| Other Organization Name | KENNYBROOK VILLAGE |
| Practice Address |
200 Sw Brookside Drive Grimes IA 50111 |
| Mailing Address |
11827 W 112th St Suite 103 Overland Park KS 66210-2726 |
| Practice Telephone | 5153693900 |
| Practice Fax Number | 5153693905 |
| Mailing Telephone | 9138904780 |
| Mailing Fax Number | 9139566564 |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2017-01-26 |
| Authorized Official Name | MR. GILBERT R WOOD (MANAGING MEMBER) |
| Authorized Official Telephone | 9135995705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Kennybrook Village | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | CCRC OF GRIMES, LLC | 11827 W 112th St Ste 103, Overland Park, KS 66210 |
| Street Address |
200 SW BROOKSIDE DRIVE |
| City | GRIMES |
| State | IA |
| Zip Code | 50111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891000147 | Wal-mart Stores Inc | Technician/Technologist | 2150 East 1st St., Grimes, IA 50111 | 2010-08-11 |
| 1134364573 | Tram Quach | Pharmacist | 608 South 18th Street, Grimes, IA 50111 | 2008-12-15 |
| 1730338625 | Ann Marie Miller | Pharmacist | 5700 Glenstone Dr, Unit 701, Grimes, IA 50111 | 2008-09-16 |
| 1548481591 | Siebert Mobility, Inc. | Contractor | 3450 Se Miehe Drive, Suite 1, Grimes, IA 50111 | 2007-05-01 |
| 1275691867 | Nicholas John Nerem | Chiropractor | 925 Gateway Dr., Suite 200, Grimes, IA 50111 | 2006-12-05 |
| 1932275252 | Holly Marie Crowson | Chiropractor | 3000 Se Grimes Blvd, Suite 500, Grimes, IA 50111 | 2006-11-28 |
| 1235158452 | Amanda Jorgensen | Dentist | 100 Sw Brookside Dr, Grimes, IA 50111 | 2006-07-19 |
| 1922065903 | Curtis R Waddingham | Specialist/Technologist | 270 Sw 1st St, Ste H, Grimes, IA 50111 | 2006-04-26 |
| 1326011578 | Grove and Platt Dental Associates Plc | Dentist | 1541 S Third Street, Suite 300, Grimes, IA 50111 | 2006-02-08 |
| 1932411212 | Erin E Swenka | Family Medicine | 250 Sw Brookside Dr, Grimes, IA 50111 | 2010-07-02 |
| Find all providers in zip 50111 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
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| 1114547395 | Bvm-phs Senior Housing Inc | Skilled Nursing Facility | 1160 Carmel Dr, Dubuque, IA 52003-7911 | 2020-04-17 |
| 1659920320 | Phs Walnut Ridge LLC | Skilled Nursing Facility | 1703 Campus Drive, Clive, IA 50325 | 2019-09-05 |
| 1992354666 | Phs Council Bluffs, Inc | Skilled Nursing Facility | 16 Valley View Drive, Council Bluffs, IA 51503 | 2019-09-05 |
| 1023679057 | Bcp Union Park, LLC | Skilled Nursing Facility | 2401 E 8th St, Des Moines, IA 50316-1717 | 2019-06-20 |
| 1639637143 | Wellspire LLC | Skilled Nursing Facility | 5508 Nw 88th St, Johnston, IA 50131-3005 | 2019-03-05 |
| 1356807101 | Accura Healthcare of Aurelia LLC | Skilled Nursing Facility | 401 W 5th St, Aurelia, IA 51005-7712 | 2019-02-18 |
| 1093286395 | Ccrc of West Des Moines, LLC | Skilled Nursing Facility | 8950 Coachlight Drive, West Des Moines, IA 50266 | 2018-12-12 |
| 1255828919 | Brio of Johnston, LLC | Skilled Nursing Facility | 6901 Peckham St, Johnston, IA 50131-3143 | 2018-04-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.