Lincoln Lutheran Home of Racine Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2269 Issued in WI

Legal business name

LINCOLN LUTHERAN HOME OF RACINE INC

Doing business as

Lincoln Village Convalescent Center

Practice address

1700 Ca Becker Drive
Racine, WI 53406

Phone

(262) 637-9751

Fax

(262) 633-3045

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Jerry Glen Apple

Title

Chief Financial Officer

Phone

(262) 898-2722

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lincoln Village Convalescent Center Doing business as

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Lincoln Lutheran Community Care Corporation

  dba Becker Shoop Center

  • Skilled Nursing Facility
  • Racine, WI
  • NPI 1871677963
  NPPES parent name

Practitioners 1

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

• Antoinette Ducrest, MD

  • Psychiatry Physician
  • New Castle, DE
  • NPI 1174549927
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215011317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 DOMANIK DRIVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53404",
            "telephone_number": "262-633-0500",
            "fax_number": "262-633-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CA BECKER DRIVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53406",
            "telephone_number": "262-637-9751",
            "fax_number": "262-633-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN LUTHERAN HOME OF RACINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "APPLE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "262-898-2722"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20129400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Village Convalescent Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lifepulse Wound & Home Healthcare Agency LLC
• Light As a Feather Therapy
• Sasia Lile
• Lillie House (Lifes Vision LLC)
• Lincoln Lutheran Community Care Corporation (Becker Shoop Center)
• Lincoln Park Nursing and Rehab LLC (Lincoln Park Nursing and Rehab)
• Samantha Lins
• Thomas J Linstroth, DDS
• Guisselle Maria Lizano Castillo, LPC
• Dawn M Llorca, DDS

• Skilled Nursing Facility in Racine, WI
• Providers in Racine, 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.