Wisdom in Age LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

47608 Issued in SD

Legal business name

WISDOM IN AGE LLC

Practice address

3704 W Main St
Rapid City, SD 57702-2139

Phone

(605) 721-9473

NPI assigned

Nov 23, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Vicki L Kennedy

Title

Manager

Phone

(605) 721-9473

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1227398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227398400000",
    "number": "1346495017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 W MAIN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022139",
            "telephone_number": "605-721-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 W MAIN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022139",
            "telephone_number": "605-721-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM IN AGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-23",
        "last_updated": "2008-11-23",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "605-721-9473",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "SD",
            "license": "47608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda Winters, PA
• Rachel Winters, DC
• Robyn Wintersteen, RPH
• Mallory Wipf, PA-C
• Tamara S Wirtz, CCC-SLP
• Errin Joy Wise, MS, RD
• Robin Nicole Wisniewski, PSY.D.
• Wiswall Adams Endodontics LLC
• Jeffrey Herbert Wiswall, D.D.S., M.S.
• Steven Frederick Wiswall, DMD, MS

• All providers in Rapid City, SD
• Adult Care Home Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2008; 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.