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PARK LANE VILLAGE
NPI 1316161839
Assisted Living Facility in Knoxville, IA

Active since April 13, 2007CLIA Certified · 2 labs
908 SOUTH PARK LANE DRIVE, KNOXVILLE, IA 50138(641) 828-7878(641) 828-2184 Get Directions Write a Review

NPPES record last updated: November 10, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Park Lane Village NPPES

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

PARK LANE VILLAGE (NPI 1316161839) is a healthcare organization registered as an assisted living facility in Knoxville, Iowa and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates and lists Mike Tryon, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1316161839
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameHOMESTEAD OF KNOXVILLE OPERATIONS LLC
Location Address908 SOUTH PARK LANE DRIVEKnoxville, IA 50138
Mailing Address3715 Sw 29th StreetTopeka, KS 66614 · (785) 272-1535 · Fax (785) 272-1480
Phone(641) 828-7878
Fax(641) 828-2184
Organization SubpartNo
Authorized OfficialMike TryonChief Financial Officer · (785) 228-7913
Enumeration DateApril 13, 2007
Last NPPES UpdateNovember 10, 2011
✔ NPI 1316161839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in IA · S0132
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
908 SOUTH PARK LANE DRIVE, Knoxville, IA 50138
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Other Names 1

Doing Business AsPark Lane Village

Other Identifiers 1

Medicaid0249361IA

CLIA Laboratory Certificates CMS CLIA 2

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 16D1031852

Homestead Of Knoxville Assisted Living · Knoxville, IA
Active · expires Oct 11, 2026
CLIA Number16D1031852
Laboratory TypeOther
Certificate Effective DateOctober 12, 2024
Certificate Expiration DateOctober 11, 2026
Laboratory DirectorBailey Stone
Laboratory Phone(641) 828-7878
Laboratory LocationHomestead Of Knoxville Assisted Living908 South Park Lane, Knoxville, IA 50138
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 16D2026644

Homestead Of Knoxville Memory Care · Knoxville, IA
Active · expires Jul 5, 2027
CLIA Number16D2026644
Laboratory TypeAssisted Living Facility
Certificate Effective DateJuly 6, 2025
Certificate Expiration DateJuly 5, 2027
Laboratory DirectorBailey Stone
Laboratory Phone(641) 828-7878
Laboratory LocationHomestead Of Knoxville Memory Care711 South Willetts Drive, Knoxville, IA 50138
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Homestead Of Knoxville Operations LLC's NPI number?

The NPI number for Homestead Of Knoxville Operations LLC is 1316161839. It was assigned to this organization in the NPPES registry on April 13, 2007. The provider is doing business as Park Lane Village.

Where is Homestead Of Knoxville Operations LLC located?

Homestead Of Knoxville Operations LLC is located at 908 South Park Lane Drive, Knoxville, IA 50138. The listed phone number is (641) 828-7878.

What is Homestead Of Knoxville Operations LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Homestead Of Knoxville Operations LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Homestead Of Knoxville Operations LLC was last updated on November 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.