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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 314000000X | Skilled Nursing Facility | 3249 | WI | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 20195300 | 05 |
Other Name | Type Code |
---|---|
Prescott Nursing and Rehabilitation Community | Doing Business As Name - Organization |
Street Address |
1505 ORRIN RD |
City | PRESCOTT |
State | WI |
Zip Code | 54021-1074 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 54021 |
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 |
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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 |
Find all providers in PRESCOTT |
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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.