Midwest Eminence Care, LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

MIDWEST EMINENCE CARE, LLC

Practice address

200 S Executive Dr Ste 101
Brookfield, WI 53005-4216

Phone

(262) 789-2759

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Crystal AveryNPI 1265968036

Title

Administrator

Phone

(262) 789-2759

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Midwest Eminence Care Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Crystal Avery

  • In Home Supportive Care Agency
  • Brookfield, WI
  • NPI 1265968036
  NPD Authorized official

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1063938264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S. EXECUTIVE DRIVE SUITE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "262-789-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S EXECUTIVE DR STE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054216",
            "telephone_number": "262-789-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EMINENCE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "262-789-2759",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100069896",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Eminence Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Irene Michor, NP, MSN
• Robert William Miclot Jr., DC
• Monica Micoliczyk
• Midline Vision Group, LLC
• Midwest Detox LLC
• Midwest Orthopedic Specialty Hospital, LLC
• Midwest Orthopedic Specialty Hospital, LLC
• Midwest Orthopedic Specialty Hospital, LLC
• Midwest Psychological Associates, LLC
• Midwest Rehabilitation Network Inc.

• Personal Care Attendant in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Personal Care Attendant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.