COUNTRYSIDE HOME (NPI# 1902881022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902881022 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE HOME |
| Practice Address |
703 N Main St Madison NE 68748-6009 |
| Practice Telephone | 4024543373 |
| Practice Fax Number | 4024546509 |
| Mailing Telephone | 4024543373 |
| Mailing Fax Number | 4024546509 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MRS. LINDA ANDERSON (ADMINISTRATOR) |
| Authorized Official Telephone | 4024543373 |
| Authorized Official Credential | ADMINISTRATOR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | ========= | NE | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | MEDICARE DME | 0637150001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598893869 | Countryside Home | Custodial Care Facility | 122 S Countryside Ln, Wellington, KS 67152-8077 | 2007-03-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | COUNTRYSIDE HOME BUILDERS , INC. | 11 Draper Woods Rd., Fiskdale, MA 01518 |
| Oregon Corporations, Companies and Business Names | COUNTRYSIDE HOME CARE | 3275 Snowy Butte Ln, Central Point, OR 97502 |
| Oregon Corporations, Companies and Business Names | COUNTRYSIDE HOME CARE II | 3243 Snowy Butte Ln, Central Point, OR 97502 |
| Oregon Corporations, Companies and Business Names | COUNTRYSIDE HOME CARE III | 271 Black Oak Dr, Medford, OR 97504 |
| Virginia Business Entities | Countryside Homecrafters LC | 9 S Augusta St, Po Box 2366, Staunton, Virginia 24402-2366 |
| Colorado Business Entities | COUNTRYSIDE HOMEOWNERS' ASSOCIATION, A COLORADO NON-PROFITCORPORATION, C.S.P. | 2619 Canton Court, Suite A, Fort Collins, CO 80525 |
| Colorado Business Entities | COUNTRYSIDE HOMES & REAL ESTATE, INC. | 12971 Elkhorn Circle, Broomfield, CO 80021 |
| Colorado Business Entities | COUNTRYSIDE HOMES INCORPORATED | 4742 N Bayou Hills Rd, Parker, CO 80134 |
| Street Address |
703 N MAIN ST |
| City | MADISON |
| State | NE |
| Zip Code | 68748-6009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656776 | Jacqueline Sue Wegener | Physical Medicine & Rehabilitation | 703 N Main St, Madison, NE 68748-6009 | 2020-10-09 |
| 1811501596 | Arbor Care Centers - Countryside LLC | Assisted Living Facility | 703 N Main St, Madison, NE 68748-6009 | 2020-09-01 |
| 1205182268 | Mariah Delmont | Physical Medicine & Rehabilitation | 703 N Main St, Madison, NE 68748-6009 | 2012-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912084641 | City of Madison | Ambulance | 211 South Lincoln, Madison, NE 68748-0527 | 2006-11-01 |
| 1558614172 | Katie L Wood | Physician Assistant | 118 W 3rd St, Madison, NE 68748-0595 | 2012-10-19 |
| 1578585048 | Gary N Bring | Dentist | 203 So. Main St., Madison, NE 68748-1207 | 2006-07-24 |
| 1144308271 | Kristi L Jagels | Physical Therapist | 119 Saddle Lane, Madison, NE 68748-6009 | 2006-11-02 |
| 1508324922 | Janet Marie Pfeifer | Registered Nurse | 700 S Kent St, Madison, NE 68748-6279 | 2019-03-05 |
| 1417415019 | Lisa Alice Holoubek | Registered Nurse | 700 S Kent St # 450, Madison, NE 68748-6279 | 2019-03-04 |
| 1932752888 | Midtown Health Center, Inc. | Clinic/Center | 700 S Kent St, Madison, NE 68748-6279 | 2019-07-19 |
| 1538712492 | Midtown Health Center, Inc. | Clinic/Center | 405 E 8th St, Madison, NE 68748-6319 | 2019-07-19 |
| 1871767913 | Taylor Creek Physical Therapy LLC | Clinic/Center | 119 Saddle Ln, Madison, NE 68748-6346 | 2008-04-19 |
| 1518599257 | Louderback Drug of Madison, Inc. | Pharmacy | 201 S Main St, Madison, NE 68748-6485 | 2020-02-11 |
| Find all providers in zip 68748 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053834747 | St. Catherine's Village, Inc | Skilled Nursing Facility | 200 Dominican Dr, Madison, MS 39110-8630 | 2017-07-25 |
| 1205201381 | Harrison County Hospital | Skilled Nursing Facility | 120 Presbyterian Avenue, Madison, IN 47250 | 2015-12-01 |
| 1649646506 | Oak Park Place of Nakoma, LLC | Skilled Nursing Facility | 4327 Nakoma Road, Madison, WI 53711 | 2015-08-14 |
| 1356629968 | Melanie Jeannine Johnston | Skilled Nursing Facility | 248 Geneva Blvd, Madison, MS 39110-7739 | 2011-07-31 |
| 1649425034 | Krizia Villanueva | Skilled Nursing Facility | 316 S Broom St, Madison, WI 53703-4076 | 2008-11-26 |
| 1326214578 | Dylan Ponchaud | Skilled Nursing Facility | 947 E Johnson St Apt 1, Madison, WI 53703-1672 | 2008-05-07 |
| 1144493404 | Sara M Bakken | Skilled Nursing Facility | 718 Jupiter Dr, Madison, WI 53718-2950 | 2008-04-08 |
| 1982888277 | Oakwood Village East Lutheran Homes, Inc | Skilled Nursing Facility | 5833 American Pkwy, Madison, WI 53718 | 2007-12-21 |
| 1316011513 | Nc Leasing, LLC | Skilled Nursing Facility | 1308 Highway 51, Madison, MS 39110-7205 | 2006-11-20 |
| 1710056940 | Watrous Nursing Center Inc. | Skilled Nursing Facility | 9 Neck Rd, Madison, CT 06443-2819 | 2006-11-06 |
| Find all providers in MADISON | ||||
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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.