EVANSVILLE MANOR, INC. (NPI# 1609863794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609863794 |
| Entity Type | Organization |
| Organization Name | EVANSVILLE MANOR, INC. |
| Practice Address |
470 Garfield Ave Evansville WI 53536-1014 |
| Practice Telephone | 6088825700 |
| Practice Fax Number | 6088820833 |
| Mailing Telephone | 6088825700 |
| Mailing Fax Number | 6088820833 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BONNIE MARTIN (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 6088825700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2259 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20147800 | 05 |
| Street Address |
470 GARFIELD AVE |
| City | EVANSVILLE |
| State | WI |
| Zip Code | 53536-1014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013566306 | Nicole Erickson | Physical Therapist | 470 Garfield Ave, Evansville, WI 53536-1099 | 2019-09-09 |
| 1205311917 | Evansville Manor Nursing and Rehab, LLC | Skilled Nursing Facility | 470 Garfield Ave, Evansville, WI 53536-1099 | 2018-09-27 |
| 1356852958 | Evm Operations LLC | Skilled Nursing Facility | 470 Garfield Ave, Evansville, WI 53536-1014 | 2017-10-23 |
| 1487172193 | Samantha Rae Arnold | Occupational Therapist | 470 Garfield Ave, Evansville, WI 53536-1014 | 2017-09-01 |
| 1730605247 | Karmen Lee Maag | Occupational Therapy Assistant | 470 Garfield Ave, Evansville, WI 53536-1014 | 2017-08-16 |
| 1700218724 | Kim Ellen Kline | Physical Therapy Assistant | 470 Garfield Ave, Evansville, WI 53536-1014 | 2013-08-01 |
| 1497029995 | Kathryn Ann Dauwalter | Occupational Therapist | 470 Garfield Ave, Evansville, WI 53536-1014 | 2012-02-29 |
| 1366744369 | Susan Dooley Conaway | Physical Therapy Assistant | 470 Garfield Ave, Evansville, WI 53536-1014 | 2010-11-23 |
| 1477722239 | Katie Ann Kulis | Occupational Therapy Assistant | 470 Garfield Ave, Evansville, WI 53536-1014 | 2008-02-26 |
| 1891986964 | Gl Healthcare | Skilled Nursing Facility | 470 Garfield Ave, Evansville, WI 53536-1014 | 2007-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851817787 | Tammy Ann Reed | Physical Therapy Assistant | 470 Garfield Avenue, Evansville, WI 53536 | 2017-08-22 |
| 1396291522 | Quadmed LLC | Clinic/Center | 101 County Highway M, Evansville, WI 53536 | 2016-08-28 |
| 1821221649 | Jeff Richards | Chiropractor | 825 Brown School Road, Evansville, WI 53536 | 2009-08-27 |
| 1336278522 | Emily Peterson | Physical Therapist | 811 Brown School Road, Evansville, WI 53536 | 2007-03-05 |
| 1295975217 | Renee Corinne Kinney | Licensed Practical Nurse | 237 W Main St, Evansville, WI 53536-1018 | 2009-03-03 |
| 1780081208 | Justin George | Physical Therapist | 341 W Main St, Evansville, WI 53536-1020 | 2014-11-26 |
| 1023079977 | Cheryl Ann Runde | Registered Nurse | 36 Garfield Ave, Evansville, WI 53536-1111 | 2006-03-30 |
| 1861683336 | Wilke Chiropractic Office Sc | Chiropractor | 503 East Main Street, Evansville, WI 53536-1131 | 2007-08-08 |
| 1134289242 | Peter J Wilke | Chiropractor | 503 E Main Street, Evansville, WI 53536-1131 | 2006-12-11 |
| 1649789058 | Ross Reinhardt | Physical Therapist | 503 E Main St, Evansville, WI 53536-1131 | 2017-09-28 |
| Find all providers in zip 53536 | ||||
| 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 |
|---|---|---|---|---|
| 1164878583 | Good Samaritan Hospital | Skilled Nursing Facility | 811 E. Baseline Road, Evansville, IN 47725-9340 | 2016-05-05 |
| 1700137353 | Trurehab LLC | Skilled Nursing Facility | 12251 Highway 41 N, Suite A, Evansville, IN 47725-7014 | 2012-09-23 |
| 1184930737 | Good Samaritan Hospital | Skilled Nursing Facility | 714 S Eickhoff Rd, Evansville, IN 47712-9060 | 2010-08-20 |
| 1053558296 | Cfb Healthcare, Inc. | Skilled Nursing Facility | 909 1st Ave, Evansville, IN 47710-1939 | 2009-01-09 |
| 1811146681 | Good Samaritan Hospital | Skilled Nursing Facility | 1701 Mcdowell Rd, Evansville, IN 47712-5431 | 2008-09-16 |
| 1609057835 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 621 W Columbia St, Evansville, IN 47710 | 2007-11-15 |
| 1932256922 | Core of Evansville, Inc. | Skilled Nursing Facility | 909 N 1st Ave, Evansville, IN 47710-1939 | 2007-01-04 |
| 1376615146 | Indiana Health & Rehabilitation Center | Skilled Nursing Facility | 650 Fairway Dr, Evansville, IN 47710-3306 | 2006-11-15 |
| 1003988700 | Indiana Health and Rehabilitation Centers | Skilled Nursing Facility | 25 S Boehne Camp Rd, Evansville, IN 47712-3101 | 2006-11-15 |
| 1659452449 | Americare Living Centers IIi, LLC | Skilled Nursing Facility | 4301 Washington Ave, Evansville, IN 47714-0678 | 2006-10-18 |
| Find all providers in EVANSVILLE | ||||
| City | EVANSVILLE |
| Zip Code | 53536 |
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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.