NPIMap

Organization Active NPI

Ridgewood

  • Skilled Nursing Facility
  • Racine, WI
National Provider Identifier
1548539323
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
4806027 Issued in WI
Legal business name
RIDGEWOOD
Practice address
3205 Wood Rd
Racine, WI 53406-5048
Phone
(262) 598-9146
NPI assigned
Dec 22, 2011
Last updated
Dec 22, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
MJCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Authorized official

Name
Mary L Swaim, COTA/L
Title
Cota/L
Phone
(262) 598-9146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4806027 WI Primary

Addresses

Primary practice location

3205 Wood Rd
Racine, WI 53406-5048

Mailing address

3205 Wood Rd
Racine, WI 53406-5048
Phone (262) 598-9146

National Provider Directory

National Provider Directory
Tax ID family
Racine County Finance8 organizations share this tax ID, including this one
Part of
Racine County Finance

Other organizations with this tax ID 7

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": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1548539323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 WOOD RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065048",
            "telephone_number": "262-598-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 WOOD RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065048",
            "telephone_number": "262-598-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MJCARE INC",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "SWAIM",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COTA/L",
        "authorized_official_telephone_number": "262-598-9146",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "4806027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.