Pine Grove Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PINE GROVE SENIOR LIVING LLC

Doing business as

Blue Jay Springs Senior Living and Memory Care

Practice address

1006 N Military Ave
Green Bay, WI 54303-4412

Phone

(920) 499-1119

NPI assigned

Oct 9, 2024

Organization subpart

No

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

Authorized official

Name

Amber Tueller

Title

Secretary

Phone

(208) 207-2726

Specialties & licenses 1

Addresses

Other names 1

• Blue Jay Springs Senior Living and Memory Care 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

Locations

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1245059864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 N MILITARY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034412",
            "telephone_number": "543-032-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 N MILITARY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034412",
            "telephone_number": "920-499-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE GROVE SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Jay Springs Senior Living and Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katelynn S Pieschek, PA-C
• Barbara Pigeon, CNM, FNP
• Kasey M Pigeon, PA-C
• Scott Elwain Pigeon, RPH
• Gauri Shailesh Pikale, MD
• Pine View Dental, LLC
• Christopher Pinn, MD
• Lisa M Piontek, MSN APNP NNP-BC
• Lisa Rachel Piontek, D.D.S
• Mary-Clare Piontek, RPH

• Assisted Living Facility in Green Bay, WI
• Providers in Green Bay, 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 Nov 19, 2025; 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.