Active NPI
Five Star Quality Care Wi LLC
- Skilled Nursing Facility
- Brookfield, WI
National Provider Identifier
1487609178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 3050
- Legal business name
- FIVE STAR QUALITY CARE WI LLC
- Practice address
- 18740 West Bluemound Road
Brookfield, WI 53045-2936 - Phone
- (262) 782-0230
- Fax
- (262) 797-8306
- NPI assigned
- May 23, 2006
- Organization subpart
- Yes
- Parent organization
- FIVE STAR QUALITY CARE WI LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Katherine E Potter
- Title
- President & Chief Executive Officer
- Phone
- (617) 796-8387
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 3050 | WI | Primary |
Addresses
Primary practice location
18740 West Bluemound Road
Brookfield, WI 53045-2936
Mailing address
18740 West Bluemound Road
Brookfield, WI 53045-2936
Phone (262) 782-0230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20187000 | Medicaid | WI |
Other names 1
- Brookfield Rehabilitation and Specialty Care Center
National Provider Directory
National Provider Directory- Part of
- Five Star Quality Care-Wi LLC
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Assisted Living Facility
- Madison, WI
- NPI 1205083185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1553644800000",
"number": "1487609178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18740 WEST BLUEMOUND ROAD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530452936",
"telephone_number": "262-782-0230",
"fax_number": "262-797-8306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18740 WEST BLUEMOUND ROAD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530452936",
"telephone_number": "262-782-0230",
"fax_number": "262-797-8306"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIVE STAR QUALITY CARE WI LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FIVE STAR QUALITY CARE WI LLC",
"enumeration_date": "2006-05-23",
"last_updated": "2019-03-27",
"status": "A",
"authorized_official_last_name": "POTTER",
"authorized_official_first_name": "KATHERINE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "617-796-8387"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "3050",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20187000",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Brookfield Rehabilitation and Specialty Care Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Brookfield Rehabilitation and Specialty Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.