MANOR CARE OF SHAWANO WI LLC (NPI# 1215984307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215984307 |
| Entity Type | Organization |
| Organization Name | MANOR CARE OF SHAWANO WI LLC |
| Other Organization Name | MANORCARE HEALTH SERVICES - SHAWANO |
| Practice Address |
1436 S Lincoln St Shawano WI 54166-3427 |
| Mailing Address |
333 N Summit St 4th Floor Attn Barry Lazarus Toledo OH 43604-1531 |
| Practice Telephone | 7155266111 |
| Practice Fax Number | 7155245708 |
| Mailing Telephone | 4192525541 |
| Mailing Fax Number | 4192525548 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2008-02-08 |
| Authorized Official Name | MR. BARRY A. LAZARUS (VICE PRESIDENT-REIMBURSEMENT) |
| Authorized Official Telephone | 4192525541 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 3175 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20200500 | 05 |
| Other Name | Type Code |
|---|---|
| ManorCare Health Services - Shawano | Doing Business As Name - Organization |
| Street Address |
1436 S LINCOLN ST |
| City | SHAWANO |
| State | WI |
| Zip Code | 54166-3427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989507 | Cassandra Peters | Speech-Language Pathologist | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2020-07-16 |
| 1881162568 | Carissa Ann Greely | Occupational Therapy Assistant | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2018-11-11 |
| 1952876880 | Haley Marie Zakrzewski | Speech-Language Pathologist | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2018-10-08 |
| 1578042297 | Heather Lynn Bannister | Physical Therapy Assistant | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2018-08-13 |
| 1407212897 | Lindsey Vidmar | Physical Therapy Assistant | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2016-01-14 |
| 1013386614 | Shawano Health Services LLC | Skilled Nursing Facility | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2015-09-24 |
| 1417336520 | Sarah Evers | Occupational Therapist | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2015-05-21 |
| 1164786802 | Elizabeth Ann Gaedtke | Speech-Language Pathologist | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2012-06-27 |
| 1750603858 | Debra K Larson | Speech-Language Pathologist | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2010-02-17 |
| 1942444112 | Janean Carol Brewington | Occupational Therapist | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2009-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134641848 | Nicole Jeannine Klotzbuecher | Optometrist | 150 County Road B, Shawano, WI 54166 | 2017-07-13 |
| 1437605714 | Jennifer Marie Franke | Counselor | 504 Lakeland St, Shawano, WI 54166 | 2016-08-28 |
| 1699017913 | Benjamin D Schlais | Family Medicine | 100 County Hwy B, Shawano, WI 54166 | 2013-03-25 |
| 1154574366 | Luke T Johnson | Speech-Language Pathologist | N3684 River Road, Shawano, WI 54166 | 2008-10-31 |
| 1902054315 | Robert Joseph Bohr Jr. | Physical Therapy Assistant | N6590 Fox Lane, Shawano, WI 54166 | 2008-08-28 |
| 1790945863 | Patricia Rae Ainsworth | Physical Therapist | 1436 South Lincoln Street, Shawano, WI 54166 | 2008-06-12 |
| 1649491820 | Shawano-gresham School District | Local Education Agency (LEA) | 1050 South Union Street, Shawano, WI 54166 | 2007-05-02 |
| 1114043387 | Thomas G Peterson | Optometrist | 150a County Road B, Shawano, WI 54166 | 2007-03-21 |
| 1740343086 | John Milton Dovorany | Dentist | 1488 E Green Bay St, Shawano, WI 54166 | 2006-12-18 |
| 1265526305 | Charles E Lamarche | Counselor | 420 E Green Bay St, Ste 201, Shawano, WI 54166 | 2006-10-03 |
| Find all providers in zip 54166 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316939861 | Evergreen Care Center LLC | Skilled Nursing Facility | 1250 S Evergreen St, Shawano, WI 54166-3514 | 2005-08-19 |
| 1790785475 | Birch Hill Care Center LLC | Skilled Nursing Facility | 1475 Birch Hill Ln, Shawano, WI 54166-3707 | 2005-07-26 |
| 1619510567 | Nsh Shawano-maple LLC | Skilled Nursing Facility | N4231 State Highway 22, Shawano, WI 54166-6130 | 2019-10-23 |
| 1548803497 | Nsh Shawano-evergreen LLC | Skilled Nursing Facility | 1250 S Evergreen St, Shawano, WI 54166-3514 | 2019-10-23 |
| 1275176125 | Nsh Shawano-birch LLC | Skilled Nursing Facility | 1475 Birch Hill Ln, Shawano, WI 54166-3707 | 2019-10-23 |
| 1013386614 | Shawano Health Services LLC | Skilled Nursing Facility | 1436 S Lincoln St, Shawano, WI 54166-3427 | 2015-09-24 |
| 1194048298 | Maple Lane Health & Rehabilitation Center LLC | Skilled Nursing Facility | N4231 State Highway 22, Shawano, WI 54166-6130 | 2010-03-04 |
| 1124028519 | County of Shawano | Skilled Nursing Facility | N4231 State Highway 22, Shawano, WI 54166-6130 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962369 | Heritage Assisted Living, LLC | Skilled Nursing Facility | 5020 S 107th St, Greenfield, WI 53228-3267 | 2020-04-30 |
| 1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
| 1831693936 | Golden Years Nursing Home, Inc. | Skilled Nursing Facility | 611 Harmony Dr, Lake Geneva, WI 53147-8800 | 2018-03-22 |
| 1801302732 | Oak Park Place of Janesville, LLC | Skilled Nursing Facility | 700 Myrtle Way, Janesville, WI 53545-9101 | 2017-12-14 |
| 1235674839 | Zachary Rader | Skilled Nursing Facility | 645 N Church St, Elkhorn, WI 53121-2204 | 2017-01-05 |
| 1982155248 | The Bethany-st. Joseph Corporation D/b/a Prairie Pointe Rehab Suites | Skilled Nursing Facility | 286 N. Willson Dr, Altoona, WI 54720 | 2016-10-20 |
| 1316492317 | Darcy Christiansen | Skilled Nursing Facility | 4427 E Pic A Dilly Dr, Janesville, WI 53546-9606 | 2016-08-19 |
| 1366895583 | Jeffrey Alan Weinshrott | Skilled Nursing Facility | 336 Wisconsin Ave, Sheboygan, WI 53081-4183 | 2016-07-22 |
| 1720433378 | Kendra Meyers | Skilled Nursing Facility | 1806 N Hume Ave Apt 4, Marshfield, WI 54449-1677 | 2016-05-02 |
| 1952756991 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 206 North Willson Drive, Altoona, WI 54720 | 2016-04-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.