Ledge View Nursing Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3105 Issued in WI

Legal business name

LEDGE VIEW NURSING CENTER

Practice address

3737 Dickinson Rd
De Pere, WI 54115-8797

Phone

(920) 336-7733

Fax

(920) 339-7885

NPI assigned

Oct 10, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Ronald J Desotell

Title

Administrator

Phone

(920) 336-7733

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104814664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 DICKINSON RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541158797",
            "telephone_number": "920-336-7733",
            "fax_number": "920-339-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 DICKINSON RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541158797",
            "telephone_number": "920-336-7733",
            "fax_number": "920-339-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEDGE VIEW NURSING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DESOTELL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-336-7733",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20171900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Lawton
• Ivy E Leasum, NP
• Marie Claude Lebel, OTA
• Callie Anne Lebrun, RD, CD
• Carissa Lebsock, BCBA
• Ell Louis Lee, D.D.S.
• Abigail Lefeber
• Tracy Lynn Legg, PTA
• Ellen Katherine Lemay, COTA
• Nicole A Lemerond, LPC-IT

• Skilled Nursing Facility in De Pere, WI
• Providers in De Pere, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.