NPIMap

Organization Active NPI

Royalrespite

  • Rural Health Clinic/Center
  • Racine, WI
National Provider Identifier
1043040413
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ROYALRESPITE
Practice address
255 N Memorial Dr
Racine, WI 53404-3428
Phone
(262) 504-0241
NPI assigned
Aug 1, 2024
Organization subpart
Yes
Parent organization
000000As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Doris V Walekr, CDCP
Title
Owner
Phone
(262) 504-0241

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Behavior Technician 106S00000X
Nutrition Education NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133NN1002X
Hospice Registered Nurse 163WH1000X
Emergency Care Certified Respiratory Therapist 2278E0002X
Home Health Agency 251E00000X
PACE Provider Organization 251T00000X
Early Intervention Provider Agency 252Y00000X
In Home Supportive Care Agency 253Z00000X
Genetics Clinic/Center 261QG0250X
Rural Health Clinic/Center 261QR1300X Primary
Adult Care Home Facility 311ZA0620X
Respite Care 385H00000X
Respite Care Camp 385HR2050X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

255 N Memorial Dr
Racine, WI 53404-3428

Mailing address

255 N Memorial Dr
Racine, WI 53404-3428
Phone (262) 504-0241

Other names 4

  • MOBILEMOGUL Doing business as
  • ROYALRESPITE Doing business as
  • WELLNESSHOPPE Doing business as
  • Wellness Shoppe Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address yourepresentative@royalrespite.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Part of
Royalrespite

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1043040413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N MEMORIAL DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534043428",
            "telephone_number": "262-504-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N MEMORIAL DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534043428",
            "telephone_number": "262-504-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYALRESPITE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "000000",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "WALEKR",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-504-0241",
        "authorized_official_credential": "CDCP"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2278E0002X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QG0250X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Genetics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yourepresentative@royalrespite.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "255 N Memorial Dr",
            "city": "Racine",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534043428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MOBILEMOGUL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ROYALRESPITE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WELLNESSHOPPE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellness Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.