NPIMap

Organization Active NPI

State of Wisconsin

  • Intellectual Disabilities Intermediate Care Facility
  • Madison, WI
National Provider Identifier
1336324946
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
STATE OF WISCONSIN
Doing business as
Rehabiliation Services
Practice address
317 Knutson Dr
Madison, WI 53704-1133
Phone
(608) 301-9382
NPI assigned
Jan 2, 2008
Organization subpart
Yes
Parent organization
CENTRAL WISCONSIN CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Authorized official

Name
Kimberly A Coplien, PT, DPT
Title
Director of Rehabilitation Services
Phone
(608) 301-9382

Specialties & licenses 1

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

Addresses

Primary practice location

317 Knutson Dr
Madison, WI 53704-1133

Mailing address

317 Knutson Dr
Madison, WI 53704-1133

Other identifiers 1

IdentifierTypeStateIssuer
41225300MedicaidWI

Other names 1

  • Rehabiliation Services Doing business as

Medicare participation

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

Intermediate care facility for individuals with intellectual disabilities certification: CCN 52G023

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
CENTRAL WISCONSIN CENTER FDD
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 1, 1982
Last certification
Aug 19, 2025
Beds
235
Ownership / control type
State
Facility address
317 Knutson Dr
Madison, WI 53704

National Provider Directory

National Provider Directory
Tax ID family
Dept of Health Social8 organizations share this tax ID, including this one
Part of
Dept of Health Social

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1336324946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 KNUTSON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 KNUTSON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041133",
            "telephone_number": "608-301-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF WISCONSIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL WISCONSIN CENTER",
        "enumeration_date": "2008-01-02",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "COPLIEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF REHABILITATION SERVICES",
        "authorized_official_telephone_number": "608-301-9382",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41225300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehabiliation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.