IDA LYN STEVENSON (NPI# 1821265638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821265638 |
| Entity Type | Individual |
| Full Name | IDA LYN STEVENSON |
| Credential | COTA/L |
| Practice Address |
2903 13th St Monroe WI 53566-2245 |
| Practice Telephone | 6085586032 |
| Mailing Telephone | 6085586032 |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2020-10-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | OCCUPATIONAL THERAPY ASSISTANT LISCENSE | 057003252 | 01 |
| WI | OCCUPATIONAL THERAPY ASSISTANT LISCENSE | 1902-27 | 01 |
| Street Address |
2903 13TH ST |
| City | MONROE |
| State | WI |
| Zip Code | 53566-2245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548752967 | Mariah Mohns | Occupational Therapy Assistant | N3150 Wi- 81, Monroe, WI 53566 | 2018-06-01 |
| 1811414907 | Yelena Gapchenko | Pharmacist | 515 22nd St., Monroe, WY 53566 | 2017-08-29 |
| 1508306283 | Hilary Domke | Occupational Therapist | N3150 Wi-81, Monroe, WI 53566 | 2017-03-01 |
| 1699132332 | Lisa Marty | Social Worker | N3152 Wi-81, Monroe, WI 53566 | 2016-01-26 |
| 1518223148 | Lauren Nibler Craddock | Dermatology | 412 18th Ave, Monroe, WI 53566 | 2012-04-09 |
| 1033482799 | Amber Gatdula | Physical Therapy Assistant | 2628 14th Street, Monroe, WI 53566 | 2012-02-10 |
| 1629361043 | Tammy Noble | Licensed Practical Nurse | N2546 Ullom Rd., Monroe, WI 53566 | 2011-05-18 |
| 1023331683 | Kristine Hudson | Registered Nurse | 1110 11th Street, Monroe, WI 53566 | 2010-03-10 |
| 1306005012 | Rosemary Ann Graham | Registered Nurse | 2413 5th Ave, Monroe, WI 53566 | 2008-06-06 |
| 1174702559 | Kelly Jo Jenson | Chiropractor | 1518 11th Street, Suite 1-2, Monroe, WI 53566 | 2007-11-01 |
| Find all providers in zip 53566 | ||||
| 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 |
|---|---|---|---|---|
| 1992106348 | The Heritage of Union County, LLC | Skilled Nursing Facility | 3510 W Highway 74, Monroe, NC 28110-8441 | 2014-09-04 |
| 1245514546 | Riverside Nursing Home, LLC | Skilled Nursing Facility | 7950 Millhaven Road, Monroe, LA 71203-9008 | 2011-10-05 |
| 1295990836 | Marci Gail Milne | Skilled Nursing Facility | 3006 Dewdrop Ct, Monroe, NC 28110-6346 | 2008-07-23 |
| 1467657304 | Northeast Louisana Veterans Home | Skilled Nursing Facility | 6700 Highway 165 N, Monroe, LA 71203-8753 | 2007-06-20 |
| 1023180734 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 516 26th Ave, Monroe, WI 53566-1531 | 2006-11-15 |
| 1033207121 | Management Company Inc | Skilled Nursing Facility | 4201 S Grand St, Monroe, LA 71202-6319 | 2006-10-11 |
| 1801996210 | Promedica Monroe Skilled Nursing and Rehab | Skilled Nursing Facility | 700 Stewart Rd, Monroe, MI 48162-5304 | 2006-09-25 |
| 1396754750 | Avalon Place, Lp | Skilled Nursing Facility | 4385 Old Sterlington Rd, Monroe, LA 71203-2360 | 2006-08-05 |
| 1912931254 | Woodlawn Manor, Inc. | Skilled Nursing Facility | 1000 Mckeen Pl, Monroe, LA 71201 | 2006-07-11 |
| 1548205255 | Beach Nursing Home Inc. | Skilled Nursing Facility | 1215 N Telegraph Rd, Monroe, MI 48162-3368 | 2006-06-17 |
| Find all providers in MONROE | ||||
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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.