NPIMap

Organization Active NPI

Prostep Rehabilitation

  • Skilled Nursing Facility
  • Waupaca, WI
National Provider Identifier
1033511316
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PROSTEP REHABILITATION
Practice address
1401 Churchill St
Waupaca, WI 54981-2027
Phone
(715) 258-8131
NPI assigned
Sep 18, 2014
Last updated
Sep 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Authorized official

Name
Kelly Goodman, OTRNPI 1528272531
Title
Regional Director of Rehab
Phone
(920) 740-2747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1401 Churchill St
Waupaca, WI 54981-2027

Mailing address

1401 Churchill St.
Waupaca, WI 54981

National Provider Directory

National Provider Directory
Tax ID family
First Coast Health and14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1033511316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CHURCHILL ST.",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "54981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CHURCHILL ST",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549812027",
            "telephone_number": "715-258-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTEP REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR OF REHAB",
        "authorized_official_telephone_number": "920-740-2747",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupaca, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.