EXTENDICARE HOMES, INC. (NPI# 1639245558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639245558 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HOMES, INC. |
| Other Organization Name | SHEBOYGAN PROGRESSIVE CARE CENTER |
| Practice Address |
1902 Mead Ave Sheboygan WI 53081-6140 |
| Mailing Address |
111 W Michigan St Milwaukee WI 53203-2903 |
| Practice Telephone | 9204588333 |
| Practice Fax Number | 9204583346 |
| Mailing Telephone | 4149088119 |
| Mailing Fax Number | 4149087105 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE) |
| Authorized Official Telephone | 4149088119 |
| Is Organization Subpart | N |
| 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 | 20182600 | 05 |
| Other Name | Type Code |
|---|---|
| Sheboygan Progressive Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740345800 | Extendicare Homes, Inc. | Assisted Living Facility | 100 E Dalke Ave, Spokane, WA 99208-1006 | 2006-12-27 |
| 1912070624 | Extendicare Homes, Inc. | Skilled Nursing Facility | 414 Robey St, Franklin, KY 42134-1034 | 2006-11-17 |
| 1043383771 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 2006-11-17 |
| 1790859486 | Extendicare Homes, Inc. | Skilled Nursing Facility | 3431 N 13th St, Sheboygan, WI 53083-2938 | 2006-11-17 |
| 1871666560 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1561 Newton Ave, Bowling Green, KY 42104-3238 | 2006-11-17 |
| 1215001862 | Extendicare Homes, Inc. | Skilled Nursing Facility | 619 W Walnut St, Milwaukee, WI 53212-3839 | 2006-11-17 |
| 1619041340 | Extendicare Homes, Inc. | Skilled Nursing Facility | 867 Mcguire Ave, Paducah, KY 42001-4036 | 2006-11-17 |
| 1255405700 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2582 Cerulean Rd, Cadiz, KY 42211-9605 | 2006-11-17 |
| 1376617837 | Extendicare Homes, Inc. | Skilled Nursing Facility | 420 E Grundy Ave, Springfield, KY 40069-1173 | 2006-11-17 |
| 1184798712 | Extendicare Homes, Inc. | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2006-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | EXTENDICARE HOMES, INC. | 3500 Lenox Road Ne, Suite 510, Atlanta, GA 30326 |
| Street Address |
1902 MEAD AVE |
| City | SHEBOYGAN |
| State | WI |
| Zip Code | 53081-6140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922636877 | Kelly Lauren Leist | Nurse Practitioner | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2020-03-27 |
| 1962064436 | Courtney F Klatt | Nurse Practitioner | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2019-07-03 |
| 1073172920 | Emilee Daehnert | Occupational Therapy Assistant | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2019-06-12 |
| 1750809547 | Nsh Progressive LLC | Skilled Nursing Facility | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2017-09-01 |
| 1841733060 | Hailey Amber Skiba | Speech-Language Pathologist | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2016-11-19 |
| 1568911956 | Constance Salm | Physical Therapy Assistant | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2016-09-26 |
| 1790140184 | Caroline Matlock | Occupational Therapy Assistant | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2015-12-29 |
| 1700254000 | Jamie Swifka | Physical Therapy Assistant | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2015-09-03 |
| 1881083228 | Fmg Mead Avenue Wisconsin LLC | Skilled Nursing Facility | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2015-01-22 |
| 1316341803 | Emily Liesener | Physical Therapist | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2014-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770053696 | Kathy Hughes Counseling, LLC | Community/Behavioral Health | 630 Riverfront Dr Ste 203, Sheboygan, WI 53081 | 2018-12-04 |
| 1780159004 | Great Lakes Clinic and Consultants, LLC | Clinic/Center | 1407 North 8th Street, Suite 203, Sheboygan, WI 53081 | 2018-10-13 |
| 1174032106 | Laura Elizabeth Manning | Registered Nurse | 325 Linocln Ave, Sheboygan, WI 53081 | 2017-09-21 |
| 1043733686 | Chasidy D Wilke | Behavioral Analyst | 2223 Terrace View Dr Apt 3a, Sheboygan, WI 53081 | 2017-07-25 |
| 1700320074 | Darlene Wilken | Counselor | 2842 S. Business Dr, Sheboygan, WI 53081 | 2016-12-06 |
| 1942652185 | Jacob Steven Son | Dentist | 3555 Wasington Ave., Sheboygan, WI 53081 | 2016-07-12 |
| 1225491749 | Cassandra Lea Loehndorf | Social Worker | 3321 S. 12th St., Sheboygan, WI 53081 | 2016-04-01 |
| 1003201112 | Jason Meinhardt | Dentist | 2115 S Memorial Pl, Sheboygan, WI 53081 | 2015-04-06 |
| 1346634110 | Christopher Lenz | Specialist/Technologist | 2920 Superior Ave., Prevea Orthopedics, Sheboygan, WI 53081 | 2015-03-19 |
| 1780008060 | James Simac | Counselor | 503 Wisconsin Ave., Sheboygan, WI 53081 | 2014-02-07 |
| Find all providers in zip 53081 | ||||
| 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 |
|---|---|---|---|---|
| 1366895583 | Jeffrey Alan Weinshrott | Skilled Nursing Facility | 336 Wisconsin Ave, Sheboygan, WI 53081-4183 | 2016-07-22 |
| 1790859486 | Extendicare Homes, Inc. | Skilled Nursing Facility | 3431 N 13th St, Sheboygan, WI 53083-2938 | 2006-11-17 |
| 1801968847 | Lss of Sheboygan, LLC | Skilled Nursing Facility | 3014 Erie Ave, Sheboygan, WI 53081-3658 | 2006-11-14 |
| 1770530164 | Beverly Enterprises - Wisconsin Inc | Skilled Nursing Facility | 3129 Michigan Ave, Sheboygan, WI 53081-3062 | 2006-05-30 |
| 1831197425 | Sheboygan Senior Community, Inc. | Skilled Nursing Facility | 3505 Cty Rd. Y, Sheboygan, WI 53083-2400 | 2005-07-08 |
| 1639635683 | Sunny Ridge Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 3014 Erie Ave, Sheboygan, WI 53081-3658 | 2019-02-14 |
| 1750809547 | Nsh Progressive LLC | Skilled Nursing Facility | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2017-09-01 |
| 1942728738 | Nsh Morningside LLC | Skilled Nursing Facility | 3431 N 13th St, Sheboygan, WI 53083-2938 | 2017-09-01 |
| 1275051021 | Nsh Meadow View LLC | Skilled Nursing Facility | 3613 S 13th St, Sheboygan, WI 53081-7253 | 2017-08-31 |
| 1770022998 | Sunny Ridge Rehabilitation Center LLC | Skilled Nursing Facility | 3014 Erie Ave, Sheboygan, WI 53081-3658 | 2017-02-21 |
| Find all providers in SHEBOYGAN | ||||
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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.