PETERSEN HEALTH CARE, INC. (NPI# 1962468769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962468769 |
| Entity Type | Organization |
| Organization Name | PETERSEN HEALTH CARE, INC. |
| Other Organization Name | MEADOWLAWN HEALTH CARE |
| Practice Address |
4656 W Kimberly Rd Davenport IA 52806-7111 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 5633915150 |
| Practice Fax Number | 5633913901 |
| Mailing Telephone | 3096918113 |
| Mailing Fax Number | 3096918622 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARK B. PETERSEN (PRESIDENT) |
| Authorized Official Telephone | 3096918113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 820624 | IA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0809459 | 05 |
| Other Name | Type Code |
|---|---|
| Meadowlawn Health Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932383973 | Petersen Health Care, Inc. | Assisted Living Facility | 160 East Walnut Street, Canton, IL 61520-2708 | 2007-12-27 |
| Street Address |
4656 W KIMBERLY RD |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52806-7111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543257 | June Swain | Nurse Practitioner | Quad City Family Physician, 3940 Marquette Street, Davenport, IA 52806 | 2019-11-21 |
| 1881055747 | Jace Carter | Chiropractor | 235 West 35th Street Suite 2d, Davenport, IA 52806 | 2016-03-18 |
| 1538468210 | Cody Krech | Dentist | 141 E 46th St, Davenport, IA 52806 | 2011-03-21 |
| 1619287216 | Robert Earl Clark | Occupational Therapist | 6623 N Main St, Davenport, IA 52806 | 2010-10-15 |
| 1689902579 | Nicholas P. Carlson | Nurse Practitioner | 3801 Marguette Street, Suite 200, Davenport, IA 52806 | 2009-12-03 |
| 1295821114 | David Lee Botsko | Dentist | 2334 W. Kimberly Road, Davenport, IA 52806 | 2006-10-05 |
| 1598712903 | Select Specialty Hospital - Quad Cities Inc | Long Term Care Hospital | 1111 West Kimberly Road, Davenport, IA 52806 | 2006-05-30 |
| 1528030350 | Warren Wright | Occupational Therapist | 1008 W 35th St, Davenport, IA 52806 | 2006-02-06 |
| 1144291568 | Gerald Wallace Hess | Chiropractor | 2711 W 63rd St, Ste #1, Davenport, IA 52806 | 2006-02-01 |
| 1487642286 | Virginia Armstrong | Chiropractor | 4811 N Brady St Ste 1a, Davenport, IA 52806 | 2005-10-06 |
| Find all providers in zip 52806 | ||||
| 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 |
|---|---|---|---|---|
| 1932362431 | Manorcare Health Services LLC | Skilled Nursing Facility | 3800 Commerce Blvd, Davenport, IA 52807-3495 | 2008-07-03 |
| 1730259813 | Lutheran Home for The Aged Association-east | Skilled Nursing Facility | 1130 W 53rd St, Davenport, IA 52806-2401 | 2006-11-08 |
| 1093819211 | Lincoln County Hospital District #3 | Skilled Nursing Facility | 10 Nichols St, Davenport, WA 99122-9729 | 2006-09-08 |
| 1871501486 | 206 Management LLC | Skilled Nursing Facility | 206 W Orange St, Davenport, FL 33837-3118 | 2006-08-03 |
| 1811922826 | Fejervary Health Care Center | Skilled Nursing Facility | 800 E Rusholme St, Davenport, IA 52803-2547 | 2006-07-11 |
| 1760420798 | Manor Care of Davenport Ia LLC | Skilled Nursing Facility | 815 E Locust St, Davenport, IA 52803-4345 | 2006-06-03 |
| 1013910553 | Kahl Home for The Aged & Infirm | Skilled Nursing Facility | 6701 Jersey Ridge Road, Davenport, IA 52807 | 2005-05-28 |
| 1639615271 | Accordius Health At St Mary, LLC | Skilled Nursing Facility | 800 E Rusholme St, Davenport, IA 52803-2547 | 2017-01-06 |
| 1619427689 | Rusholme Healthcare, Inc. | Skilled Nursing Facility | 800 E Rusholme St, Davenport, IA 52803-2547 | 2016-10-13 |
| 1104255488 | 206 Golden LLC | Skilled Nursing Facility | 206 W Orange St, Davenport, FL 33837-3118 | 2013-11-06 |
| Find all providers in DAVENPORT | ||||
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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.