Renee M Coleman

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Practice address

1971 21 15/16 St
Rice Lake, WI 54868-8583

Phone

(715) 234-2122

Fax

(715) 234-2122

NPI assigned

Nov 20, 2008

Last updated

Nov 20, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Red Star LLC

  dba Havenwood Hoimes

  • Adult Care Home Facility
  • Eleva, WI
  • NPI 1316723687
  NPD Authorized official

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1114172954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 COUNTRY AIRE DRIVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "54868",
            "telephone_number": "715-234-2122",
            "fax_number": "715-234-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 21 15/16 ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688583",
            "telephone_number": "715-234-2122",
            "fax_number": "715-234-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "RENEE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vidya Sagar Reddy Cirra, MD
• City of Rice Lake (Rice Lake Fire Department)
• Ashley Clark, RN
• Clear Path Clinic SC
• Zachary Alan Cole, DC
• Chad Michael Collins, LCSW
• Kimberly Leah Collymore, FNP
• Coram Consulting LLC
• Michelle R Corbin, OTR
• Cornerstone Caregiving East LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Rice Lake, WI
• Providers in Rice Lake, WI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.