Graves Enterprises Inc D/B/a Oregon Manor

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

20100100 Issued in WI

Legal business name

GRAVES ENTERPRISES INC D/B/A OREGON MANOR

Practice address

354 N Main St
Oregon, WI 53575-1426

Phone

(608) 835-3535

Fax

(608) 835-3890

NPI assigned

Apr 15, 2013

Last updated

Dec 12, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas L Graves, LNHA

Title

President

Phone

(608) 835-3535

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1295178713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 N MAIN ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535751426",
            "telephone_number": "608-835-3535",
            "fax_number": "608-835-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 N MAIN ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535751426",
            "telephone_number": "608-835-3535",
            "fax_number": "608-835-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAVES ENTERPRISES INC D/B/A OREGON MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-835-3535",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "20100100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20100100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114001666",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonya Socorro Garza
• David Alfred Gebhardt, SAC
• Cheryl Jo Ginther, P.T.
• Kelly L Goodrich, RN
• Joshua D Graber, DDS
• Tyler J Grunow, MD
• Kari Sweeney Hahn, PT
• Hamm Chiropractic S.C. (Hamm Chiropractic & Wellness)
• Daniel Edward Hamm, D.C.
• Lesley Ann Harrop, RN

• Skilled Nursing Facility in Oregon, WI
• Providers in Oregon, 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 Dec 12, 2013; 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.