NPIMap

Organization Active NPI

Greenbriar Apartments, LLC

  • Assisted Living Facility
  • Baraboo, WI
National Provider Identifier
1154751709
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
0013806 Issued in WI
Legal business name
GREENBRIAR APARTMENTS, LLC
Practice address
1350 Jefferson St
Baraboo, WI 53913-1795
Phone
(608) 356-9213
Fax
(608) 356-1859
NPI assigned
Nov 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Shale Parker
Title
General Manager
Phone
(562) 234-5739

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 0013806 WI Primary

Addresses

Primary practice location

1350 Jefferson St
Baraboo, WI 53913-1795

Mailing address

PO Box 185
Manhattan Beach, CA 90267-0185
Phone (562) 234-5739

Other identifiers 1

IdentifierTypeStateIssuer
0013806OtherWID.H.S.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1154751709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902670185",
            "telephone_number": "562-234-5739",
            "fax_number": "818-748-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 JEFFERSON ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131795",
            "telephone_number": "608-356-9213",
            "fax_number": "608-356-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIAR APARTMENTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "SHALE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "562-234-5739"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "0013806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D.H.S.",
            "identifier": "0013806",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.