NPIMap

Organization Active NPI

Sunny Ridge

  • Skilled Nursing Facility
  • Sheboygan, WI
National Provider Identifier
1477762797
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1801968847 Issued in WI
Legal business name
SUNNY RIDGE
Practice address
3014 Erie Ave
Sheboygan, WI 53081-3658
Phone
(920) 453-7049
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Authorized official

Name
Barbara Jentges
Title
Occupational Therapist
Phone
(920) 453-7049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1801968847 WI Primary

Addresses

Primary practice location

3014 Erie Ave
Sheboygan, WI 53081-3658

Mailing address

3014 Erie Ave
Sheboygan, WI 53081-3658

Other identifiers 1

IdentifierTypeStateIssuer
2236-026OtherWIREGISTERED OT

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1477762797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813658",
            "telephone_number": "920-453-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNY RIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "JENTGES",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "920-453-7049"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "1801968847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED OT",
            "identifier": "2236-026",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.