CCG PRESCOTT, INC


Address: 1505 Orrin Rd, Prescott, WI 54021-1074
Phone: 7152625661

CCG PRESCOTT, INC (NPI# 1922090521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922090521
Entity Type Organization
Organization Name CCG PRESCOTT, INC
Other Organization Name PRESCOTT NURSING AND REHABILITATION COMMUNITY
Practice Address 1505 Orrin Rd
Prescott
WI 54021-1074
Mailing Address 5000 Hakes Dr
Suite 600
Norton Shores
MI 49441-5574
Practice Telephone 7152625661
Practice Fax Number 7152624899
Mailing Telephone 2317996870
Mailing Fax Number 2317990250
Enumeration Date 2005-08-19
Last Update Date 2008-01-23
Authorized Official Name KEITH YODER (CFO)
Authorized Official Telephone 6144160600
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 314000000X Skilled Nursing Facility 3249 WI Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
WI 20195300 05

Other Provider/Organization Names

Other Name Type Code
Prescott Nursing and Rehabilitation Community Doing Business As Name - Organization

Office Location

Street Address 1505 ORRIN RD
City PRESCOTT
State WI
Zip Code 54021-1074

Providers in the same location

NPI Name Taxonomy Address Enumeration
1467051714 Rebekah Kimlinger Physical Therapist 1505 Orrin Rd, Prescott, WI 54021-1074 2020-10-19
1548886278 Sara Michele Jenkins Occupational Therapy Assistant 1505 Orrin Rd, Prescott, WI 54021-1074 2020-06-18
1245700624 Caitlin Ann Johnson Occupational Therapy Assistant 1505 Orrin Rd, Prescott, WI 54021-1074 2018-11-28
1164991980 Sarah Hei Occupational Therapist 1505 Orrin Rd, Prescott, WI 54021-1074 2018-11-21
1861960791 Janna M Johnson Physical Therapist 1505 Orrin Rd, Prescott, WI 54021-1074 2018-11-08
1124528393 Morgan Lee Williamson Occupational Therapy Assistant 1505 Orrin Rd, Prescott, WI 54021-1074 2018-02-14
1992160535 Molly Kapping Speech-Language Pathologist 1505 Orrin Rd, Prescott, WI 54021-1074 2015-12-28
1639557507 Emily Stejskal Speech-Language Pathologist 1505 Orrin Rd, Prescott, WI 54021-1074 2015-05-12
1407250368 Kaeleigh Adami Physical Therapist 1505 Orrin Rd, Prescott, WI 54021-1074 2014-10-21
1477987956 Melissa Merth Occupational Therapy Assistant 1505 Orrin Rd, Prescott, WI 54021-1074 2013-09-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922104801 Gerald Otto Gatzke Dentist 127 Broad St N, Prescott, WI 54021-0000 2006-09-16
1336328038 School District of Prescott Local Education Agency (LEA) 1220 Saint Croix St, Prescott, WI 54021-1042 2007-10-30
1336407386 Hillary Jane Hunter Dentist 1267 Walnut St, Prescott, WI 54021-1060 2012-04-27
1144320193 Michael Joseph Toninato Dentist 1015 Campbell St N, Prescott, WI 54021-1157 2006-09-22
1093113789 Prescott Family Dental Dentist 1015 Campbell St N, Prescott, WI 54021-1157 2014-12-11
1730627514 Carl Manuel Calabrese Chiropractor 716 Saint Croix St, Prescott, WI 54021-1445 2017-02-01
1770015257 One Life Chiropractic LLC Chiropractor 716 Saint Croix St, Prescott, WI 54021-1445 2017-04-03
1619935319 Patricia A Zentner Registered Nurse 170 Broad St S, Prescott, WI 54021-1643 2006-05-02
1063517399 John Patrick Lee Optometrist 110 Broad St N, Prescott, WI 54021-1702 2006-09-13
1528367521 Donald Burton Schueller Chiropractor 219 Broad St N, Prescott, WI 54021-1703 2011-03-16
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Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033295266 Hillcrest Care & Rehab LLC Skilled Nursing Facility 1421 West Second Street North, Prescott, AR 71857-3342 2006-10-31
1477635415 Southwestern Medical Centers Az Skilled Nursing Facility 864 Dougherty St, Prescott, AZ 86305-1841 2006-10-19
1346335338 District No 1 of Linn and Bourbon Counties Kansas Skilled Nursing Facility 301 East Miller St., Prescott, KS 66767-4103 2006-10-04
1871500983 Ksj, LLC Skilled Nursing Facility 700 Manor Rd, Prescott, AR 71857-2800 2006-08-02
1235161233 Sandretto Hills Nursing Center 2 Skilled Nursing Facility 1045 Sandretto Dr, Prescott, AZ 86305-3717 2006-07-07
1497793079 Life Care Centers of America, Inc. Skilled Nursing Facility 1045 Scott Dr, Prescott, AZ 86301-1731 2006-06-03
1003438789 Prescott Snf Operations, LLC Skilled Nursing Facility 700 Manor Rd, Prescott, AR 71857-2800 2020-05-15
1508491465 Prescott Ops, LLC Skilled Nursing Facility 700 Manor Rd, Prescott, AR 71857-2800 2020-03-11
1841833258 Vbnc Ops, Inc. Skilled Nursing Facility 700 Manor Rd, Prescott, AR 71857-2800 2019-10-18
1548640840 Watson Woods Healthcare, Inc. Skilled Nursing Facility 1045 Scott Dr, Prescott, AZ 86301-1731 2015-06-02
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Competitor

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City PRESCOTT
Zip Code 54021

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Dataset Information

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.

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