Medicaid

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

MEDICAID

Practice address

1125 Geneva Rd
Menasha, WI 54952-1505

Phone

(920) 450-8323

NPI assigned

Mar 27, 2006

Organization subpart

No

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

Authorized official

Name

Miss Lori Ann Farragh

Title

RN

Phone

(920) 450-8323

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1336109776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 GENEVA RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521505",
            "telephone_number": "920-450-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 GENEVA RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521505",
            "telephone_number": "920-450-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAID",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FARRAGH",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "920-450-8323",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul McCarty
• Margaret McEwen
• Sean M McLuen, DDS
• Tansi McQueen
• Emma McSweeney
• Elysabeth Meehan, APSW
• Abigail Joy Meehl, MS, CCC-SLP
• Esther Melsha, APNP
• Menasha Family Dental LLC
• Menasha Joint School District

• Custodial Care Facility in Menasha, WI
• Providers in Menasha, WI by specialty
• Custodial Care Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.