BEVERLY ENTERPRISES - WISCONSIN, INC (NPI# 1275576951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275576951 |
| Entity Type | Organization |
| Organization Name | BEVERLY ENTERPRISES - WISCONSIN, INC |
| Other Organization Name | GOLDEN LIVINGCENTER - SOUTH SHORE |
| Practice Address |
1915 E Tripoli St. Francis WI 53207 |
| Practice Telephone | 4144833611 |
| Mailing Telephone | 4144833611 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2014-07-17 |
| Authorized Official Name | HOLLY RASMUSSEN-JONES (SECRETARY) |
| Authorized Official Telephone | 4792014835 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEVERLY HEALTH AND REHABILITATION SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20-1233-00 | 05 | |
| WI | SECURITY HP | 525477 | 01 |
| Other Name | Type Code |
|---|---|
| Golden LivingCenter - South Shore | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225085640 | Beverly Enterprises - Wisconsin, Inc | Skilled Nursing Facility | 1640 Shawano Ave, Green Bay, WI 54303-3214 | 2006-05-30 |
| Street Address |
1915 E TRIPOLI |
| City | ST. FRANCIS |
| State | WI |
| Zip Code | 53207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497304117 | Diane Wisch | Technician | 3602 S. 4th, Mil, WI 53207 | 2019-09-05 |
| 1811384464 | Megan O Bedolla | Emergency Medicine | 2338 E Ohio Ave, Milwaukee, WI 53207 | 2015-04-21 |
| 1255677563 | Jon Arthur Toppen | Counselor | 2637 S Fulton St, Milwaukee, WI 53207 | 2012-12-14 |
| 1720316730 | Paula Maria Ortega Flores | Massage Therapist | 2121 South Kinnickinnic Ave, Suite 3, Milwaukee, WI 53207 | 2009-12-02 |
| 1306087127 | Theron Mills | Counselor | 3073 S. Chase Ave., Suite 326, Milwaukee, WI 53207 | 2009-03-09 |
| 1841438769 | Counseling & Transition Center Inc | Clinic/Center | 3073 S. Chase Ave, Suite 326, Milwaukee, WI 53207 | 2009-01-30 |
| 1679727812 | Well-rounded, LLC | Clinic/Center | 2455 S. Howell Ave., Milwaukee, WI 53207 | 2008-11-14 |
| 1316154024 | Christian T. Harteau | Student in an Organized Health Care Education/Training Program | 3174 S Howell Ave, Milwaukee, WI 53207 | 2007-05-16 |
| 1316008303 | Thomas Fisher | Clinical Neuropsychologist | 2419 S. Lenox Street, Milwaukee, WI 53207 | 2006-12-13 |
| 1750470811 | David Alan Duter | Technician, Other | Uscg Sector Lake Michigan/hs Div, 2420 S. Lincoln Memorial Dr., Milwaukee, WI 53207 | 2006-10-12 |
| Find all providers in zip 53207 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| Find all providers with the same taxonomy | ||||
| City | ST. FRANCIS |
| Zip Code | 53207 |
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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.