Methodist Manor Health Center, Inc.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

METHODIST MANOR HEALTH CENTER, INC.

Practice address

8520 W Oklahoma Ave
West Allis, WI 53227-4604

Phone

(414) 607-4291

Fax

(414) 607-4530

NPI assigned

Mar 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. James Enlund

Title

President & Ceo

Phone

(414) 607-4100

Specialties & licenses 10

Addresses

Other identifiers 1

Other names 1

• Olsen Medical Clinic Doing business as

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1538136254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 S 84TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532273703",
            "telephone_number": "414-607-4100",
            "fax_number": "414-607-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8520 W OKLAHOMA AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532274604",
            "telephone_number": "414-607-4291",
            "fax_number": "414-607-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MANOR HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "ENLUND",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "414-607-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32865700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olsen Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anica Merritt
• Jennifer Mesko
• Paul A Messling III, MS, BCBA
• Methodist Manor Health Center Inc
• Methodist Manor Health Center, Inc.
• Methodist Manor Inc
• Methodist Manor of Waukesha, Inc.
• Methodist Manor, Inc.
• Metro Milwaukee Medical Inc
• Metta Vista Mental Health LLC

• Health Service Clinic/Center in West Allis, WI
• Providers in West Allis, WI by specialty
• Health Service Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.