Williams Bay Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3220 Issued in WI

Legal business name

WILLIAMS BAY CARE CENTER LLC

Practice address

146 Clover St
Williams Bay, WI 53191-9779

Phone

(262) 245-6400

Fax

(262) 245-9271

NPI assigned

Aug 23, 2005

Organization subpart

No

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

Authorized official

Name

Robert M Parkins

Title

Cfo

Phone

(920) 364-9754

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ATRIUM POST ACUTE CARE OF WILLIAMS BAY Doing business as

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1386637544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549112444",
            "telephone_number": "920-991-9072",
            "fax_number": "920-749-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 CLOVER ST",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531919779",
            "telephone_number": "262-245-6400",
            "fax_number": "262-245-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMS BAY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "PARKINS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-364-9754"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20188300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATRIUM POST ACUTE CARE OF WILLIAMS BAY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Daniel Talamo, RBT
• Karen Targo
• Monica Tomasello
• Jessica Urewicz
• Deborah A Ward
• Elisabeth Ann Williams, LCSW
• Jessica M Wriedt, MSW, APSW
• Tammy Lynn Wright, REGISTERED NURSE

• All providers in Williams Bay, WI
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.