NPIMap

Organization Active NPI

Manor Care Pewaukee

  • Skilled Nursing Facility
  • Waukesha, WI
National Provider Identifier
1548404791
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1997-27 Issued in WI
Legal business name
MANOR CARE PEWAUKEE
Practice address
N26W23977 Watertown Rd
Waukesha, WI 53188-1006
Phone
(262) 523-0933
NPI assigned
Apr 30, 2009
Last updated
Apr 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Authorized official

Name
Kaelan Cleone Pieper
Title
Cota
Phone
(262) 523-0933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1997-27 WI Primary

Addresses

Primary practice location

N26W23977 Watertown Rd
Waukesha, WI 53188-1006

Mailing address

N26W23977 Watertown Rd
Waukesha, WI 53188-1006

Other identifiers 1

IdentifierTypeStateIssuer
20199600MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Manor Care of Pewaukee4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1548404791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N26W23977 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N26W23977 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881006",
            "telephone_number": "262-523-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE PEWAUKEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "PIEPER",
        "authorized_official_first_name": "KAELAN",
        "authorized_official_middle_name": "CLEONE",
        "authorized_official_title_or_position": "COTA",
        "authorized_official_telephone_number": "262-523-0933"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "1997-27",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20199600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.