Active NPI
St Paul Elder Services Inc
- Nursing Facility/Intermediate Care Facility
- Kaukauna, WI
National Provider Identifier
1053549980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- Legal business name
- ST PAUL ELDER SERVICES INC
- Practice address
- 316 E 14TH St
Kaukauna, WI 54130-3304 - Phone
- (920) 766-6020
- NPI assigned
- Jun 30, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Miller
- Title
- Management
- Phone
- (920) 766-6020
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | Primary |
Addresses
Primary practice location
316 E 14TH St
Kaukauna, WI 54130-3304
Mailing address
316 E 14TH St
Kaukauna, WI 54130-3304
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1267747200000",
"number": "1053549980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 E 14TH ST",
"city": "KAUKAUNA",
"state": "WI",
"postal_code": "541303304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 E 14TH ST",
"city": "KAUKAUNA",
"state": "WI",
"postal_code": "541303304",
"telephone_number": "920-766-6020"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST PAUL ELDER SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-06-30",
"last_updated": "2010-03-05",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "MARY",
"authorized_official_title_or_position": "MANAGEMENT",
"authorized_official_telephone_number": "920-766-6020"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kaukauna, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.