FMG North 13TH Street Wisconsin LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG NORTH 13TH STREET WISCONSIN LLC

Doing business as

Morningside Health Center

Practice address

3431 N 13TH St
Sheboygan, WI 53083-2938

Phone

(920) 457-5046

Fax

(920) 457-4753

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

• Morningside Health Center Doing business as

Locations

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": "1457740250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 N 13TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530832938",
            "telephone_number": "920-457-5046",
            "fax_number": "920-457-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 N 13TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530832938",
            "telephone_number": "920-457-5046",
            "fax_number": "920-457-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG NORTH 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": "Morningside Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jerilyn M Flipse
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• Mary Dana Foggetti, DO
• Mai Sing Follett, RD
• Adesoji Mayowa Folorunsho, MD
• Forefront Dermatology, S.C.

• 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.