FIVE STAR QUALITY CARE-WI, LLC (NPI# 1417944612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417944612 |
| Entity Type | Organization |
| Organization Name | FIVE STAR QUALITY CARE-WI, LLC |
| Other Organization Name | MITCHELL MANOR |
| Practice Address |
5301 West Lincoln Avenue West Allis WI 53219-1652 |
| Mailing Address |
400 Centre Street Newton MA 02458 |
| Practice Telephone | 4146157200 |
| Practice Fax Number | 4146157260 |
| Mailing Telephone | 6177968387 |
| Mailing Fax Number | 6177968385 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2019-03-27 |
| Authorized Official Name | KATHERINE E POTTER (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6177968387 |
| Is Organization Subpart | Y |
| Parent Organization Name | FIVE STAR QUALITY CARE-WI, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 3181 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20201200 | 05 |
| Other Name | Type Code |
|---|---|
| Mitchell Manor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215246848 | Five Star Quality Care-wi, LLC | Assisted Living Facility | 8351 Sheridan Rd, Kenosha, WI 53143-6339 | 2010-09-30 |
| Street Address |
5301 WEST LINCOLN AVENUE |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53219-1652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588262323 | Tammi T Wisniewski | Hearing Instrument Specialist | 4847 W. Forest Home Avenue, Greenfield, WI 53219 | 2020-10-14 |
| 1174052344 | Adam Blaha | Physical Therapy Assistant | 2622 South 66th Street, Milwaukee, WI 53219 | 2017-06-09 |
| 1700281920 | Mary Beth Menarek | Counselor | 6574 W. Beloit Road, West Allis, WI 53219 | 2014-10-30 |
| 1780959767 | James Stanley Ziolkowski | Electrodiagnostic Medicine | 9330 W. Lincln Ave, West Allis, WI 53219 | 2012-03-09 |
| 1568752707 | Carey M Kromarek | Social Worker | 5757 W. Oklahoma Ave, Suite 203, Milwaukee, WI 53219 | 2011-04-08 |
| 1275834988 | Debra L Felzer | Registered Nurse | 7123 W Stuth Place, West Allis, WI 53219 | 2010-11-11 |
| 1528290327 | Miguel Angel Bautista | Acupuncturist | 4318 W. Foresthowe Ave., Milwaukee, WI 53219 | 2009-08-13 |
| 1629211487 | Ruth Irene Young | Physical Therapy Assistant | 2027 S. 79th Street, West Allis, WI 53219 | 2009-04-09 |
| 1053591818 | Linda St. Louis | Nurse Practitioner | 6030 W. Oklahoma Avenue, Milwaukee, WI 53219 | 2007-11-09 |
| 1811185812 | John Stuart Lanham | Podiatrist | 5720 W Oklahoma Avenue, Milwaukee, WI 53219 | 2007-10-04 |
| Find all providers in zip 53219 | ||||
| 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 |
|---|---|---|---|---|
| 1245638378 | Sara Roark | Skilled Nursing Facility | 9047 W Greenfiled Ave, West Allis, WI 53214-2808 | 2014-12-05 |
| 1902016090 | Mary Jude Health Care, Inc. | Skilled Nursing Facility | 9806 W Lincoln Ave, West Allis, WI 53227-2234 | 2007-05-23 |
| 1598750671 | Lexington Healthcare LLC | Skilled Nursing Facility | 9047 W Greenfield Ave, West Allis, WI 53214-2808 | 2005-09-15 |
| 1780285148 | Aria At Mitchell Manor | Skilled Nursing Facility | 5301 W Lincoln Ave, West Allis, WI 53219-1652 | 2020-11-03 |
| 1124483714 | Meadowmere and Mitchell Manor Senior Living | Skilled Nursing Facility | 5301 W Lincoln Ave, West Allis, WI 53219-1652 | 2015-12-23 |
| 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 | WEST ALLIS |
| Zip Code | 53219 |
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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.