Willmar Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WILLMAR CARE CENTER LLC

Practice address

500 Russell St NW
Willmar, MN 56201-2583

Phone

(320) 235-3181

NPI assigned

Dec 16, 2010

Last updated

May 8, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

DNR THREE LLCAs reported in NPPES

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

Authorized official

Name

Garett Robertson

Title

Ceo

Phone

(801) 296-5105

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1639472426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RUSSELL ST NW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012583",
            "telephone_number": "320-235-3181",
            "fax_number": "320-235-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 RUSSELL ST NW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012583",
            "telephone_number": "320-235-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLMAR CARE CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DNR THREE LLC",
        "enumeration_date": "2010-12-16",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "GARETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-296-5105"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639472426",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Wiese, MSW LICSW
• Deanna Wilde, MSW, LICSW
• Priscilla K Willander, PA-C
• Kristen Anne Williamson, RD, LDN
• Willmar Autism Services LLC
• Willmar Chiropractic Clinic P.a.
• Willmar Commons Nursing & Rehabilitation, Inc.
• Willmar Dental Clinic
• Willmar Family Dentistry, P.a.
• Willmar Family Dentistry, PA

• Skilled Nursing Facility in Willmar, MN
• Providers in Willmar, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.