JERSEY RIDGE PLACE, L.L.C.
NPI 1609058767
Assisted Living Facility in Davenport, IA

Q: What is Jersey Ridge Place, L.L.C.'s NPI number?

The NPI number for Jersey Ridge Place, L.L.C. is 1609058767. It was assigned to this organization in the NPPES registry on November 30, 2007.

Q: What is Jersey Ridge Place, L.L.C.'s specialty?

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

Active since November 30, 2007CLIA 16D1045049 · Waiver

5605 JERSEY RIDGE RD, DAVENPORT, IA 52807(563) 355-2027(563) 441-9227 Get Directions Write a Review

NPPES record last updated: November 30, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jersey Ridge Place, L.l.c. NPPES

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

JERSEY RIDGE PLACE, L.L.C. (NPI 1609058767) is a healthcare organization registered as an assisted living facility in Davenport, Iowa and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through September 5, 2027 and lists Karen Mccoy, Director, as its authorized official.

NPPES Registry Identity

NPI1609058767

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameJERSEY RIDGE PLACE, L.L.C.

Location Address5605 JERSEY RIDGE RDDavenport, IA 52807-3132

Mailing Address5605 Jersey Ridge RdDavenport, IA 52807-3132 · (563) 355-2027 · Fax (563) 441-9227

Phone(563) 355-2027

Fax(563) 441-9227

Organization SubpartNo

Authorized OfficialKaren MccoyDirector · (563) 355-2027

Enumeration DateNovember 30, 2007

✔ NPI 1609058767 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 · S0079

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.

5605 JERSEY RIDGE RD, Davenport, IA 52807

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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 16D1045049

Jersey Ridge Place Retirement Community · Davenport, IA

Active · expires Sep 5, 2027

CLIA Number16D1045049

Laboratory TypeOther

Certificate Effective DateSeptember 6, 2025

Certificate Expiration DateSeptember 5, 2027

Laboratory DirectorNiki Gillies

Laboratory Phone(563) 355-2027

Laboratory LocationJersey Ridge Place Retirement Community5605 Jersey Ridge Road, Davenport, IA 52807

CLIA data matches this NPI record on: Address 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 Jersey Ridge Place, L.L.C.'s NPI number?

The NPI number for Jersey Ridge Place, L.L.C. is 1609058767. It was assigned to this organization in the NPPES registry on November 30, 2007.

Where is Jersey Ridge Place, L.L.C. located?

Jersey Ridge Place, L.L.C. is located at 5605 Jersey Ridge Rd, Davenport, IA 52807. The listed phone number is (563) 355-2027.

What is Jersey Ridge Place, L.L.C.'s specialty?

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

Does Jersey Ridge Place, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D1045049) is associated with this NPI, valid through September 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jersey Ridge Place, L.L.C. was last updated on November 30, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.