NPIMap

Organization Active NPI

Thedacare, Incorporated

Doing business as Peabody Manor

  • Skilled Nursing Facility
  • Appleton, WI
National Provider Identifier
1215084207
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THEDACARE, INCORPORATED
Doing business as
Peabody Manor
Practice address
2600 S Heritage Woods Dr
Appleton, WI 54915-1408
Phone
(920) 225-7764
NPI assigned
Jan 4, 2007
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
William Flett
Title
Cfo
Phone
(920) 454-4013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X WI Primary

Addresses

Primary practice location

2600 S Heritage Woods Dr
Appleton, WI 54915-1408

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 225-7771

Other names 1

  • Peabody Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Health Care Clin20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1215084207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-225-7771",
            "fax_number": "920-225-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S HERITAGE WOODS DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151408",
            "telephone_number": "920-225-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "FLETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-454-4013"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peabody Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.