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EASTERN STAR MASONIC HOME
NPI 1619046596
Custodial Care Facility in Boone, IA

Active since November 07, 2006CLIA Certified · 3 labs
715 W MAMIE EISENHOWER AVE, BOONE, IA 50036(515) 432-5274(515) 432-5276 Get Directions Write a Review

NPPES record last updated: January 27, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Eastern Star Masonic Home NPPES

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

EASTERN STAR MASONIC HOME (NPI 1619046596) is a healthcare organization registered as a custodial care facility in Boone, Iowa and active in the NPI registry since November 2006. The organization holds 3 active CLIA laboratory certificates and lists Scott Dylan Armstrong, Director Of Compliance, as its authorized official.

NPPES Registry Identity

NPI1619046596
Entity TypeOrganization
Primary Taxonomy311Z00000X
Legal Business NameEASTERN STAR MASONIC HOME
Location Address715 W MAMIE EISENHOWER AVEBoone, IA 50036-3930
Mailing Address715 W Mamie Eisenhower AveBoone, IA 50036-3930 · (515) 432-5274 · Fax (515) 432-5276
Phone(515) 432-5274
Fax(515) 432-5276
Organization SubpartNo
Authorized OfficialScott Dylan ArmstrongDirector Of Compliance · (515) 709-4398
Enumeration DateNovember 7, 2006
Last NPPES UpdateJanuary 27, 2025
NPPES CertifiedJanuary 27, 2025
✔ NPI 1619046596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care FacilityNursing & Custodial Care Facilities
Taxonomy Code311Z00000X
License✔ Licensed in IA · R-268
Definition
A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel.
715 W MAMIE EISENHOWER AVE, Boone, IA 50036
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Other Identifiers 2

Medicaid0890210IA
MedicaidX000298224IA

CLIA Laboratory Certificates CMS CLIA 3

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 16D2242587

Eastern Star Masonic Home Rcf · Boone, IA
Active · expires Nov 8, 2027
CLIA Number16D2242587
Laboratory TypeRcf
Certificate Effective DateNovember 9, 2025
Certificate Expiration DateNovember 8, 2027
Laboratory DirectorScott Armstrong
Laboratory Phone(515) 432-5274
Laboratory LocationEastern Star Masonic Home Rcf715 W 3rd St, Boone, IA 50036
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 16D2242590

Eastern Star Masonic Home Courtyard Terrace Al · Boone, IA
Active · expires Nov 8, 2027
CLIA Number16D2242590
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 9, 2025
Certificate Expiration DateNovember 8, 2027
Laboratory DirectorScott Armstrong
Laboratory Phone(515) 432-5274
Laboratory LocationEastern Star Masonic Home Courtyard Terrace Al715 W 3rd St, Boone, IA 50036
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 16D0382648

Eastern Star Masonic Home · Boone, IA
Active · expires Jul 22, 2027
CLIA Number16D0382648
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJuly 23, 2025
Certificate Expiration DateJuly 22, 2027
Laboratory DirectorScott Armstrong
Laboratory Phone(515) 432-5274
Laboratory LocationEastern Star Masonic Home715 West Third Street, Boone, IA 50036
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

EASTERN STAR MASONIC HOME
Assisted Living Facility
715 W MAMIE EISENHOWER AVE
BOONE, IA 50036
Boone County (515) 433-4406
EASTERN STAR MASONIC HOME
Skilled Nursing Facility
715 W MAMIE EISENHOWER AVE
BOONE, IA 50036
Boone County (515) 432-5274
RYAN HAVERKAMP PT
Physical Therapist (Geriatrics)
715 W MAMIE EISENHOWER AVE
BOONE, IA 50036
Boone County (515) 432-5274

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 Eastern Star Masonic Home's NPI number?

The NPI number for Eastern Star Masonic Home is 1619046596. It was assigned to this organization in the NPPES registry on November 7, 2006.

Where is Eastern Star Masonic Home located?

Eastern Star Masonic Home is located at 715 W Mamie Eisenhower Ave, Boone, IA 50036. The listed phone number is (515) 432-5274.

What is Eastern Star Masonic Home's specialty?

The primary specialty registered for this NPI is Custodial Care Facility with taxonomy code 311Z00000X.

Does Eastern Star Masonic Home hold CLIA laboratory certificates?

Yes. 3 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 Eastern Star Masonic Home was last updated on January 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.