FMG South 13TH Street Wisconsin LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG SOUTH 13TH STREET WISCONSIN LLC

Doing business as

Meadow View Manor

Practice address

3613 S 13TH St
Sheboygan, WI 53081-7253

Phone

(920) 458-4040

Fax

(920) 458-0474

NPI assigned

Jan 16, 2015

Organization subpart

No

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

Authorized official

Name

David Keating

Title

Authorized Official

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Meadow View Manor Doing business as

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1376932178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 S 13TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530817253",
            "telephone_number": "920-458-4040",
            "fax_number": "920-458-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 S 13TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530817253",
            "telephone_number": "920-458-4040",
            "fax_number": "920-458-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG SOUTH 13TH STREET WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadow View Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Float Doctor LLC
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• Ryan Flynn, ATC, LAT
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• FMG North 13TH Street Wisconsin LLC (Morningside Health Center)
• Mary Dana Foggetti, DO
• Mai Sing Follett, RD
• Adesoji Mayowa Folorunsho, MD
• Forefront Dermatology, S.C.
• Laura Elizabeth Fornal, M.S.

• Skilled Nursing Facility in Sheboygan, WI
• Providers in Sheboygan, 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 Jan 16, 2015; 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.