NPIMap

Organization Active NPI

Mequon Jewish Campus, Inc

  • Skilled Nursing Facility
  • Mequon, WI
National Provider Identifier
1548337603
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5017 Issued in WI
Legal business name
MEQUON JEWISH CAMPUS, INC
Practice address
10995 N Market St
Mequon, WI 53092-4952
Phone
(262) 478-1500
Fax
(262) 478-0355
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Paul Fiscus
Title
Administrator
Phone
(262) 478-1501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5017 WI Primary

Addresses

Primary practice location

10995 N Market St
Mequon, WI 53092-4952

Mailing address

1414 N Prospect Ave
Milwaukee, WI 53202-3018
Phone (262) 478-1500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548337603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 N PROSPECT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023018",
            "telephone_number": "262-478-1500",
            "fax_number": "262-478-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10995 N MARKET ST",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530924952",
            "telephone_number": "262-478-1500",
            "fax_number": "262-478-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEQUON JEWISH CAMPUS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FISCUS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "262-478-1501",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "5017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.