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GRUNDY CARE CENTER
NPI 1063878767
Nursing Facility/Intermediate Care Facility in Grundy Center, IA

Active since January 11, 2016CLIA 16D0384620 · Waiver
102 E J AVE, GRUNDY CENTER, IA 50638(319) 824-5436(319) 824-5808 Get Directions Write a Review

NPPES record last updated: June 10, 2016. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Grundy Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRUNDY CARE CENTER (NPI 1063878767) is a healthcare organization registered as a nursing facility/intermediate care facility in Grundy Center, Iowa and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Jamie Culp, Controller, as its authorized official.

NPPES Registry Identity

NPI1063878767
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NamePREMIER ESTATES 504, LLC
Location Address102 E J AVEGrundy Center, IA 50638-2031
Mailing Address5115 E State Road 64Bradenton, FL 34208-5509 · (941) 758-4745 · Fax (941) 751-2135
Phone(319) 824-5436
Fax(319) 824-5808
Organization SubpartNo
Authorized OfficialJamie CulpController · (941) 758-4745
Enumeration DateJanuary 11, 2016
Last NPPES UpdateJune 10, 2016
✔ NPI 1063878767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in IA · 380377
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
102 E J AVE, Grundy Center, IA 50638
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Other Names 1

Doing Business AsGrundy Care Center

Other Identifiers 2

Medicare OSCAR/certification165241IA
Medicaid0800181IA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 16D0384620

Grundy Care Center · Grundy Center, IA
Active · expires Aug 31, 2028
CLIA Number16D0384620
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorMolly Ott
Laboratory Phone(319) 824-5436
Laboratory LocationGrundy Care Center102 East J Avenue, Grundy Center, IA 50638
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OPCO GRUNDY CENTER, IA, LLC
Skilled Nursing Facility
102 E J AVE
GRUNDY CENTER, IA 50638
Grundy County (319) 824-5436
WAVERLEY - IOWA, INC.
Skilled Nursing Facility
102 E J AVE
GRUNDY CENTER, IA 50638
Grundy County (319) 824-5436
GRUNDY CARE CENTER, INC.
Skilled Nursing Facility
102 E J AVE
GRUNDY CENTER, IA 50638
Grundy County (319) 824-5436
LORA BRUNKHORST COTA
Occupational Therapy Assistant
102 E J AVE
GRUNDY CENTER, IA 50638
Grundy County (319) 824-5683

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premier Estates 504, LLC's NPI number?

The NPI number for Premier Estates 504, LLC is 1063878767. It was assigned to this organization in the NPPES registry on January 11, 2016. The provider is doing business as Grundy Care Center.

Where is Premier Estates 504, LLC located?

Premier Estates 504, LLC is located at 102 E J Ave, Grundy Center, IA 50638. The listed phone number is (319) 824-5436.

What is Premier Estates 504, LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Premier Estates 504, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D0384620) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premier Estates 504, LLC was last updated on June 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.