NPIMap

Organization Active NPI

Presbyterian Homes of Wisconsin, Inc.

Doing business as Dickson Hollow

  • Rehabilitation Clinic/Center
  • Menomonee Falls, WI
National Provider Identifier
1417644188
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PRESBYTERIAN HOMES OF WISCONSIN, INC.
Doing business as
Dickson Hollow
Presbyterian Homes and Services Rehabilitation
Practice address
W156N4881 Pilgrim Rd
Menomonee Falls, WI 53051-6920
Phone
(651) 631-6570
NPI assigned
Apr 21, 2023
Last updated
Aug 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Authorized official

Name
Ashley Leigh RueNPI 1649908765
Title
Director of Rehabilitation
Phone
(612) 599-4469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

W156N4881 Pilgrim Rd
Menomonee Falls, WI 53051-6920

Mailing address

2845 Hamline Ave N
Roseville, MN 55113-7127
Phone (651) 631-6415

Other names 2

  • Dickson Hollow Doing business as
  • Presbyterian Homes and Services Rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230317002328 WI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7618341439 Receives reassigned benefits from 20 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waukesha, WI; Menomonee Falls, WI; Pewaukee, WI; Muskego, WI; Germantown, WI; Oconomowoc, WI

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Homes and Services Rehabilitation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1417644188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 HAMLINE AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137127",
            "telephone_number": "651-631-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W156N4881 PILGRIM RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530516920",
            "telephone_number": "651-631-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOMES OF WISCONSIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "RUE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "DIRECTOR OF REHABILITATION",
        "authorized_official_telephone_number": "612-599-4469"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dickson Hollow",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presbyterian Homes and Services Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.