Shepherds Baptist Ministries Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SHEPHERDS BAPTIST MINISTRIES INC

Practice address

1805 15TH Ave
Union Grove, WI 53182-1527

Phone

(262) 878-5620

Fax

(262) 878-9285

NPI assigned

Jul 18, 2016

Organization subpart

No

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

Authorized official

Name

Karyn Borucki

Title

Controller

Phone

(262) 878-5620

Specialties & licenses 1

Addresses

Other names 1

• Shepherds Ministries Doing business as

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1407209109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 15TH AVE",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 15TH AVE",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821527",
            "telephone_number": "262-878-5620",
            "fax_number": "262-878-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERDS BAPTIST MINISTRIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "BORUCKI",
        "authorized_official_first_name": "KARYN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "262-878-5620"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherds Ministries",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Mary Ruechel, MSW, LCSW
• Catherine A Russell, MSW, LCSW, DCSW
• Claire M Schallhorn, APNP, FNP-C
• Anne M Schlimgen, MD
• Catrice Lantz Schoenfeldt, LPC-IT
• Lisa M. Simonds, M.D.
• Colleen Skott
• Tyler Joseph Smith, PA-C
• Tracey Solfest, PTA
• Sports Physical Therapy & Rehab Specialist SC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Union Grove, WI
• Providers in Union Grove, WI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.