COTTAGE GROVE PLACE
NPI 1366421281
Nursing Facility/Intermediate Care Facility in Cedar Rapids, IA

Q: What is Cottage Grove Place's NPI number?

The NPI number for Cottage Grove Place is 1366421281. It was assigned to this organization in the NPPES registry on January 10, 2006.

Q: What is Cottage Grove Place's specialty?

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

Q: What quality rating does Cottage Grove Place have?

CMS rates Cottage Grove Place 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

Active since January 10, 2006CLIA 16D0924489 · Waiver

3/5

Overall Rating

2115 1ST AVE SE, CEDAR RAPIDS, IA 52402(319) 363-2420(319) 297-5646 Get Directions Write a Review

NPPES record last updated: August 28, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Cottage Grove Place NPPES

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

COTTAGE GROVE PLACE (NPI 1366421281) is a healthcare organization registered as a nursing facility/intermediate care facility in Cedar Rapids, Iowa and active in the NPI registry since January 2006. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists William C. Jacobson, Board Chair, as its authorized official.

NPPES Registry Identity

NPI1366421281

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameCOTTAGE GROVE PLACE

Location Address2115 1ST AVE SECedar Rapids, IA 52402

Mailing Address2115 1st Ave SeCedar Rapids, IA 52402-6353 · (319) 363-2420 · Fax (319) 297-5646

Phone(319) 363-2420

Fax(319) 297-5646

Organization SubpartNo

Authorized OfficialWilliam C. JacobsonBoard Chair · (319) 363-2420

Enumeration DateJanuary 10, 2006

Last NPPES UpdateAugust 28, 2019

✔ NPI 1366421281 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 · 570783

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.

2115 1ST AVE SE, Cedar Rapids, IA 52402

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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 16D0924489

Cottage Grove Place · Cedar Rapids, IA

Active · expires Jan 30, 2027

CLIA Number16D0924489

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateJanuary 31, 2025

Certificate Expiration DateJanuary 30, 2027

Laboratory DirectorMichon Scott

Laboratory Phone(319) 363-2420

Laboratory LocationCottage Grove Place2115 First Avenue SE, Cedar Rapids, IA 52402

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Cottage Grove Place (CMS certification number 165322), from CMS Care Compare.

Cottage Grove Place

Nursing home · Cedar Rapids, IA

3/5 CMS Overall Rating

OwnershipNon profit - Other

CMS Certification Number165322

Certified Beds64 beds45 residents per day on average

Medicare & Medicaid Participant SinceMay 7, 1997

Resident & Family CouncilResident council

Continuing care retirement community Automatic sprinkler system

CMS Star Ratings

Quality Measures

Based on a select set of clinical quality measures.

4/5

Long-Stay Quality

Quality of care delivered to long-term residents.

3/5

Short-Stay Quality

Quality of care delivered to short-term and rehabilitation residents.

5/5

Staffing

Based on nursing staff hours relative to resident needs.

4/5

Weighted Health Inspection Score

Lower scores are better; the score summarizes deficiencies found on recent inspections.

35.33

Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing

nurse aide 3.48 · LPN 0.71 · RN 0.76

4.96 hrs per resident per day

Weekend Nurse Staffing

4.23 hrs per resident per day

Physical Therapist Staffing

0.07 hrs per resident per day

Nursing Staff Turnover

Share of nursing staff who left the facility within the past year.

50%

Registered Nurse Turnover

71.4%

Administrators Who Have Left

In the past year.

Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents

Substantiated Complaints

Fines

1 totaling $3,250.00

Medicare Payment Denials

Total Penalties

Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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Other Providers at the Same Location NPPES 12

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

JENNIFER LYNN LARSEN PTA

Physical Therapy Assistant