Kewaunee Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3198 Issued in WI

Legal business name

KEWAUNEE CARE CENTER LLC

Doing business as

D/B/A ATRIUM POST ACUTE CARE OF KEWAUNEE

Practice address

1308 Lincoln St
Kewaunee, WI 54216-1606

Phone

(920) 388-4111

Fax

(920) 388-3955

NPI assigned

Aug 23, 2005

Organization subpart

No

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

Authorized official

Name

Robert M Parkins

Title

Cfo

Phone

(920) 364-9754

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• D/B/A ATRIUM POST ACUTE CARE OF KEWAUNEE Doing business as

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1588657704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549112444",
            "telephone_number": "920-991-9072",
            "fax_number": "920-749-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 LINCOLN ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161606",
            "telephone_number": "920-388-4111",
            "fax_number": "920-388-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEWAUNEE CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "PARKINS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-364-9754"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20189400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D/B/A ATRIUM POST ACUTE CARE OF KEWAUNEE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey H Jenswold, MSW CICSW CADC
• Rebecca M Kasten, LMT
• Tricia Lynn Keister, R.N.
• Kenneth J & Marilyn M Secor
• Kenneth J & Marilyn M Secor
• Kewaunee Chiropractic Works LLC
• Kewaunee Hometown Pharmacy LLC
• Kewaunee School District
• Kelly J Kovnesky, LPC-IT
• Jacob Kumpfer, LMFT-IT

• Skilled Nursing Facility in Kewaunee, WI
• Providers in Kewaunee, 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 May 20, 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.