Organization Active NPI

Pleasantville Home Care Agency

  • Home Health Agency
  • Milwaukee, WI
National Provider Identifier
1043874985
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PLEASANTVILLE HOME CARE AGENCY
Practice address
4200 N Holton St Ste 100
Milwaukee, WI 53212-1064
Phone
(414) 909-0296
Fax
(414) 962-4003
NPI assigned
Apr 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Authorized official

Name
Keith Martin Jr.
Title
President
Phone
(414) 759-6059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4200 N Holton St Ste 100
Milwaukee, WI 53212-1064

Mailing address

4200 N Holton St Ste 100
Milwaukee, WI 53212-1064
Phone (414) 909-0296

National Provider Directory

National Provider Directory

Locations

4200 N Holton St
Ste 100
Milwaukee, WI 53212
Phone (414) 909-0296

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1043874985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 N HOLTON ST STE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121064",
            "telephone_number": "414-909-0296",
            "fax_number": "414-962-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 N HOLTON ST STE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121064",
            "telephone_number": "414-909-0296",
            "fax_number": "414-962-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANTVILLE HOME CARE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-759-6059",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.