Peshtigo Health Care, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2989 Issued in WI

Legal business name

PESHTIGO HEALTH CARE, LLC

Practice address

620 Harper Ave
Peshtigo, WI 54157-1134

Phone

(715) 582-4148

Fax

(715) 582-4756

NPI assigned

May 24, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Simone M Miller, NHA

Title

Administrator

Phone

(715) 582-4148

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Whispering Oaks Care Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023011939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 HARPER AVE",
            "city": "PESHTIGO",
            "state": "WI",
            "postal_code": "541571134",
            "telephone_number": "715-582-4148",
            "fax_number": "715-582-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 HARPER AVE",
            "city": "PESHTIGO",
            "state": "WI",
            "postal_code": "541571134",
            "telephone_number": "715-582-4148",
            "fax_number": "715-582-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PESHTIGO HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "715-582-4148",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20183500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113343",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whispering Oaks Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walid Omer, M.D
• Anna Jo Oninski, OTA
• Jeffrey W. Orear, D.D.S.
• Carol L Orwig, FNPC
• Theresa Patenaude, LPC
• Peshtigo Hometown Pharmacy LLC
• Peshtigo School District
• Faith C Pristel-Miller
• Rennes Assisted Living Corp
• Rennes Health & Rehab Centers

• Skilled Nursing Facility in Peshtigo, WI
• Providers in Peshtigo, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.