NPIMap

Organization Active NPI

County of Grant - Orchard Manor FDD

Doing business as Orchard Manor Nursing Home

  • Intellectual Disabilities Intermediate Care Facility
  • Lancaster, WI
National Provider Identifier
1265429278
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
3109 Issued in WI
Legal business name
COUNTY OF GRANT - ORCHARD MANOR FDD
Doing business as
Orchard Manor Nursing Home
Practice address
8800 Hwy 61
Lancaster, WI 53813-9306
Phone
(608) 723-2113
Fax
(608) 723-2210
NPI assigned
Oct 4, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Donna Haines, N.H.A.
Title
Administrator
Phone
(608) 723-2113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 3109 WI Primary

Addresses

Primary practice location

8800 Hwy 61
Lancaster, WI 53813-9306

Mailing address

8800 Hwy 61
Lancaster, WI 53813-9306
Phone (608) 723-2113

Other identifiers 2

IdentifierTypeStateIssuer
21050300MedicaidWI
0834840001OtherDMERC

Other names 1

  • Orchard Manor Nursing Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265429278. Details of each certification follow.

  • CCN 52G043 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 52G043

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ORCHARD MANOR FDD
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 9, 1988
Last certification
Jul 24, 2025
Beds
25
Ownership / control type
County
Facility address
8800 Hwy 61
Lancaster, WI 53813

National Provider Directory

National Provider Directory
Tax ID family
Unified Community SRVS14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

8800 US Highway 61
Lancaster, WI 53813
Phone (608) 723-2113

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265429278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 HWY 61",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538139306",
            "telephone_number": "608-723-2113",
            "fax_number": "608-723-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 HWY 61",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538139306",
            "telephone_number": "608-723-2113",
            "fax_number": "608-723-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF GRANT - ORCHARD MANOR FDD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAINES",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "608-723-2113",
        "authorized_official_credential": "N.H.A."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "WI",
            "license": "3109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21050300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0834840001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orchard Manor Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, WI

Sources for this page

Verify at the official NPI Registry.