NPIMap

Organization Active NPI

Lakeview Neurorehab Center Midwest, Inc

Doing business as Lakeview Specialty Hospital and Rehab

  • Long Term Care Hospital
  • Waterford, WI
National Provider Identifier
1396726873
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
LAKEVIEW NEUROREHAB CENTER MIDWEST, INC
Doing business as
Lakeview Specialty Hospital and Rehab
Practice address
1701 Sharp Rd
Waterford, WI 53185-5214
Phone
(262) 534-7297
Fax
(262) 534-7257
NPI assigned
Nov 10, 2005
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Christopher Scott Slover
Title
Ceo
Phone
(511) 773-8076

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Rehabilitation Hospital 283X00000X
Psychiatric Residential Treatment Facility 323P00000X
Land Ambulance 3416L0300X WI
Long Term Care Hospital 282E00000X Primary

Addresses

Primary practice location

1701 Sharp Rd
Waterford, WI 53185-5214

Mailing address

1701 Sharp Rd
Waterford, WI 53185-5214
Phone (262) 534-7297

Other identifiers 2

IdentifierTypeStateIssuer
11022181MedicaidWI
11022100MedicaidWI

Other names 1

  • Lakeview Specialty Hospital and Rehab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040214000196 WI Part B Supplier - Clinic/Group Practice 6709770274 Receives reassigned benefits from 4 practitioners
Practice locations: Waterford, WI
O20040311000908 WI Part A Provider - Hospital 6709770274 1 other NPI on this enrollment
Practice locations: Waterford, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396726873. Details of each certification follow.

Hospital certification: CCN 522005

Legal name
LAKEVIEW NEUROREHAB CENTER MIDWEST INC
Doing business as
LAKEVIEW SPECIALTY HOSPITAL AND REHAB
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Oct 1, 1998
Last certification
Sep 9, 2011
Beds
39
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Incorporated
Sep 23, 1996 in WI
Enrollment address
1701 Sharp Road
Waterford, WI 53185-5214
Other Hospital Practice Location
Hospital subgroups
Long-term

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Lakeview Specialty Hospital & Rehab CenterCCN 522005 · All quality measures
Ownership
For profit
Certified
Oct 1, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Beds
39

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Angela Cholip Johnson Individual Contracted Managing Employee Jan 14, 2019
Corporate Director Jan 14, 2019
Operational/Managerial Control Jan 14, 2019
Christopher Slover Individual 5% Or Greater Direct Ownership Interest Feb 13, 2014 100%
Lakeview Management Inc Organization, Austin, TX Corporation 5% Or Greater Direct Ownership Interest Feb 1, 2014 100%

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1396726873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SHARP RD",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531855214",
            "telephone_number": "262-534-7297",
            "fax_number": "262-534-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SHARP RD",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531855214",
            "telephone_number": "262-534-7297",
            "fax_number": "262-534-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW NEUROREHAB CENTER MIDWEST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "SLOVER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "511-773-8076"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11022181",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11022100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Specialty Hospital and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, WI

Sources for this page

Verify at the official NPI Registry.