HOMESTEAD OF SHENANDOAH OPERATIONS LLC
NPI 1598416620
Assisted Living Facility in Shenandoah, IA

NPI Status: Active since January 11, 2022

Contact Information

601 HARRISON ST
SHENANDOAH, IA
ZIP 51601
Phone: (712) 246-2194

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 16D2257885
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 04-11-2026

About HOMESTEAD OF SHENANDOAH OPERATIONS LLC

This page provides the complete NPI Profile along with additional information for Homestead Of Shenandoah Operations Llc, a provider established in Shenandoah, Iowa operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1598416620 assigned on January 2022. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Cody Fulks Cpa (Cfo)

NPI
1598416620
Provider Name
HOMESTEAD OF SHENANDOAH OPERATIONS LLC
Entity Type
Organization
Location Address
601 HARRISON ST SHENANDOAH, IA 51601
Location Phone
(712) 246-2194
Mailing Address
3024 SW WANAMAKER RD STE 300 TOPEKA, KS 66614
Mailing Phone
(785) 272-1535
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-11-2022
Last Update Date
01-11-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CODY FULKS CPA

Authorized Official Title
CFO
Authorized Official Phone
(785) 272-1535

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
16D2257885
Facility Type
Assisted Living Facility
Certificate Effective Date
April 12, 2024
Certificate Expiration Date
April 11, 2026
Laboratory Director
LEEANN DAVIS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Homestead Of Shenandoah Operations Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1598416620
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25188811264
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 8 + 8 + 8 + 1 + 1 + 2 + 6 + 4 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1598416620 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1083041206SHENANDOAH IOWA ASSISTE LIVING FACILITY LLC
Organization
Alzheimer Center (Dementia Center)601 HARRISON ST
SHENANDOAH, IA 51601
(712) 246-2194

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1598416620, enumerated in the NPI registry as an "organization" on January 11, 2022

The provider is located at 601 Harrison St Shenandoah, Ia 51601 and the phone number is (712) 246-2194

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

The provider's CLIA number is 16D2257885 for a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on January 11, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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