Sun Prairie Health Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2598 Issued in WI

Legal business name

SUN PRAIRIE HEALTH CARE CENTER, LLC

Practice address

228 W Main St
Sun Prairie, WI 53590-2908

Phone

(608) 251-1171

Fax

(608) 825-4390

NPI assigned

Oct 12, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Edwin M. Kruchten

Title

Owner

Phone

(608) 849-5016

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1265420319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W MAIN ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902908",
            "telephone_number": "608-251-1171",
            "fax_number": "608-825-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W MAIN ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902908",
            "telephone_number": "608-251-1171",
            "fax_number": "608-825-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN PRAIRIE HEALTH CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "KRUCHTEN",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-849-5016",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20186100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall Howard Straub, DDS
• Ellen J Sullivan, LCSW
• Kevin A. Sullivan, L.I.S.W.
• Sun Prairie Area School District
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• Sun Prairie Hometown Pharmacy LLC (Sun Prairie Hometown Pharmacy)
• Sun Prairie Laser Pain Center
• Sun Prairie Ops, LLC (New Perspective - Sun Prairie)
• Sun Prairie Osl Operating LLC

• Skilled Nursing Facility in Sun Prairie, WI
• Providers in Sun Prairie, 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 Jan 31, 2008; 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.