FMG West Mitchell Street Wisconsin LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG WEST MITCHELL STREET WISCONSIN LLC

Doing business as

Mercy Residential & Rehabilitation

Practice address

2727 W Mitchell St
Milwaukee, WI 53215-2259

Phone

(414) 383-3699

Fax

(414) 383-3866

NPI assigned

Jan 22, 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

• Mercy Residential & Rehabilitation Doing business as

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1497144836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 W MITCHELL ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152259",
            "telephone_number": "414-383-3699",
            "fax_number": "414-383-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W MITCHELL ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152259",
            "telephone_number": "414-383-3699",
            "fax_number": "414-383-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG WEST MITCHELL STREET WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "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": "Mercy Residential & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Theresa Flynn-O'Brien, M.D.
• George David Flynn, CRC, LPC
• Grace Ann Flynn
• Sarah C Flynn, PHARMD
• FMG South 43Rd Street Wisconsin LLC
• FMG West Ramsey Avenue Wisconsin LLC
• Melissa Danielle Fockel, MSW LCSW
• Focus Home Healthcare, LLC
• Focus Transport
• Jessica Darcy Fodrocy, APNP

• Skilled Nursing Facility in Milwaukee, WI
• Providers in Milwaukee, 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 22, 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.