Platinum Communities - Racine LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PLATINUM COMMUNITIES - RACINE LLC

Doing business as

The Pillars at Crystal Bay

Practice address

3950 N Main St
Racine, WI 53402-3683

Phone

(262) 639-1100

Fax

(262) 833-0370

NPI assigned

Apr 22, 2020

Organization subpart

No

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

Authorized official

Name

John Teresinski

Title

Managing Director

Phone

(414) 940-6608

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Pillars at Crystal Bay Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1194345942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST STE 305",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272141",
            "telephone_number": "414-940-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 N MAIN ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534023683",
            "telephone_number": "262-639-1100",
            "fax_number": "262-833-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM COMMUNITIES - RACINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "TERESINSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "414-940-6608"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DHS",
            "identifier": "0017709",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pillars at Crystal Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Pippin, RN
• Leigh Pitts, PA
• Douglas Plagemann, R.N.
• Planned Parenthood of Wisconsin
• Jack A Plate, LCSW,LMFT
• Angel L Platzer
• Podomedik Clinics
• Martin James Poe, PSY.D.
• Elizabeth Ann Polo, BS, CSAC, CSIT
• Nicholas Reinhart Pope, D.C.

• Assisted Living Facility in Racine, WI
• Providers in Racine, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.