Active NPI
Saint John's Communities, Inc.
- Skilled Nursing Facility
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2611
- Legal business name
- SAINT JOHN'S COMMUNITIES, INC.
- Practice address
- 1840 N Prospect Ave
Milwaukee, WI 53202-1975 - Phone
- (414) 272-2022
- Fax
- (414) 831-6760
- NPI assigned
- Mar 8, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Renee Elizabeth Anderson
- Title
- Vice President
- Phone
- (414) 831-6880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2611 | WI | Primary |
Addresses
Primary practice location
1840 N Prospect Ave
Milwaukee, WI 53202-1975
Mailing address
1840 N Prospect Ave
Milwaukee, WI 53202-1975
Phone (414) 272-2022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20129300 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040924000336 | WI | Part A Provider - Skilled Nursing Facility | 7113917543 | Practice locations: Milwaukee, WI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1295866325. Details of each certification follow.
Skilled nursing facility certification: CCN 525539
- Legal name
- SAINT JOHN'S COMMUNITIES, INC.
- Doing business as
- SAINT JOHNS ON THE LAKE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1994
- Last certification
- Apr 24, 2024
- Beds
- 27
- Ownership / control type
- Church Related
- Organization structure
- Corporation
- Incorporated
- Apr 3, 1941 in WI
- Enrollment address
- 1840N Prospect Ave
Milwaukee, WI 53202-1975 - Nursing home name
- SAINT JOHNS ON THE LAKE
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Saint Johns on the Lake
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Jul 1, 1994
- Medicare certification status
- Active
- Certified beds
- 27
National Provider Directory
National Provider Directory- Tax ID family
- Saint Johns Communities Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic/Center
- Milwaukee, WI
- NPI 1609321173
Ownership & related parties
All disclosed owners & managing parties 44
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Renee Anderson | Corporate Officer | Jul 1, 2011 | 100% |
| Adp of the SNF | Jul 1, 2011 | ||
| Antonio Henderson | Adp of the SNF | Jun 22, 2020 | |
| William Fry | Adp of the SNF | May 1, 2024 | |
| Lakeshia Exum-Pryor | Adp of the SNF | Jul 23, 2018 | |
| Dan Lemminger | Corporate Officer | Oct 3, 2011 | |
| Adp of the SNF | Oct 3, 2011 | ||
| Matthew Loyd | Operational/Managerial Control | Jan 16, 2021 | |
| Adp of the SNF | Jan 18, 2021 | ||
| Erin Burke | Adp of the SNF | Nov 4, 2019 | |
| Rachel a Saltness | Operational/Managerial Control | Oct 1, 2024 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Kare Technologies LLC | Adp of the SNF | Jan 1, 2023 | |
| Hometown Hospice & Homecare Inc | Adp of the SNF | Sep 17, 2014 | |
| Hearing Care at Home LLC | Adp of the SNF | Dec 8, 2022 | |
| Brighton Hospice Wisconsin LLC | Adp of the SNF | Aug 7, 2023 | |
| Matthew Gunter | Adp of the SNF | Jun 1, 2024 | |
| The Medical College of Wisconsin Inc | Operational/Managerial Control | Oct 1, 2024 | |
| Adp of the SNF | Jun 23, 2025 | ||
| Integrated Therapy Managment Partners, LLC | Adp of the SNF | Feb 1, 2024 | |
| Cassandra Anderson | Adp of the SNF | Mar 14, 2022 | |
| Davis Clinical Consulting | Adp of the SNF | Dec 30, 2024 | |
| Dorothy S Petitt | Operational/Managerial Control | Oct 18, 2021 | |
| Adp of the SNF | Oct 18, 2021 | ||
| Matthew Scott Coburn | Adp of the SNF | May 1, 2021 | |
| Kirsten Hildebrand | Adp of the SNF | May 1, 2023 | |
| Melissa Geszvain | Adp of the SNF | Sep 3, 2019 | |
| Dietitians on Demand Corporate Solutions, LLC | Adp of the SNF | Jan 31, 2022 | |
| Polly W Beal | Adp of the SNF | May 2, 2014 | |
| Community Foot and Ankle Clinic Inc | Adp of the SNF | Feb 26, 2019 | |
| Guardian Pharmacy of Madison, LLC | Adp of the SNF | Aug 1, 2023 | |
| Helene Butler | Adp of the SNF | May 24, 1999 | |
| Madison Medical Affiliates Inc | Adp of the SNF | Dec 5, 2013 | |
| Betty Arndt | Adp of the SNF | May 1, 2022 | |
| Daniel Patrinos | Adp of the SNF | May 1, 2023 | |
| Judith Moon | Adp of the SNF | May 2, 2015 | |
| Cazmer Whiteside | Adp of the SNF | May 13, 2024 | |
| Legacy Hospice Cares LLC | Adp of the SNF | Apr 13, 2022 | |
| Preferred Dentistry Associates, LLC | Adp of the SNF | Jul 1, 2024 | |
| Saint John's Communities, Inc. | Operational/Managerial Control | Jul 1, 1994 | |
| Adp of the SNF | Jul 1, 1994 | ||
| Direct Ownership Interest | Jul 1, 1994 | 100% | |
| Diane Beckley Milner | Adp of the SNF | May 1, 2018 | |
| David E Eager | Adp of the SNF | May 1, 2023 | |
| Alan Kelnhofer | Adp of the SNF | Jan 12, 2025 | |
| Kathy Armbruster | Adp of the SNF | Oct 1, 2016 | |
| Richard Schreiner | Adp of the SNF | May 1, 2024 | |
| Anne Luther | Adp of the SNF | Aug 29, 2007 | |
| Behavioral Solutions Inc | Adp of the SNF | Oct 1, 2024 | |
| US Bank National Association | 5% Or Greater Mortgage Interest | Dec 9, 2015 | 46.4% |
| Lee Coppernoll | Adp of the SNF | May 1, 2018 | |
| Omar Mass | Adp of the SNF | Feb 14, 2022 |
Owners & managing parties with NPI records 11
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Community Based Hospice Care Agency
- Brookfield, WI
- NPI 1518432749
Adp of the SNF
-
dba Mallatt's Home Care Pharmacy
- Long Term Care Pharmacy
- Madison, WI
- NPI 1043707987
Adp of the SNF
-
dba Guardian Pharmacy of Wisconsin
- Long Term Care Pharmacy
- West Allis, WI
- NPI 1578038022
Adp of the SNF
-
dba St Croix Hospice
- Community Based Hospice Care Agency
- Waukesha, WI
- NPI 1508209438
Adp of the SNF
-
- Community Based Hospice Care Agency
- Elm Grove, WI
- NPI 1184136939
Adp of the SNF
-
- General Practice Physician
- Milwaukee, WI
- NPI 1588695746
Adp of the SNF
-
- Clinic/Center
- Milwaukee, WI
- NPI 1609321173
Adp of the SNF, Direct Ownership Interest, Operational/Managerial Control
-
- Geriatric Medicine (Internal Medicine) Physician
- Milwaukee, WI
- NPI 1134748270
Adp of the SNF, Operational/Managerial Control
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Adp of the SNF, Operational/Managerial Control
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Clinic/Center
- Milwaukee, WI
- NPI 1609321173
Practitioners & affiliated clinicians
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Milwaukee, WI
- NPI 1134748270
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1295866325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 N PROSPECT AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532021975",
"telephone_number": "414-272-2022",
"fax_number": "414-831-6760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 N PROSPECT AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532021975",
"telephone_number": "414-272-2022",
"fax_number": "414-831-6760"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAINT JOHN'S COMMUNITIES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-08",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "RENEE",
"authorized_official_middle_name": "ELIZABETH",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "414-831-6880"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "2611",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20129300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.