NPIMap

Organization Active NPI

Methodist Manor Inc

  • Assisted Living Facility
  • West Allis, WI
National Provider Identifier
1649247453
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
NA-CBRF Issued in WI
Legal business name
METHODIST MANOR INC
Practice address
3023 S 84TH St
West Allis, WI 53227-3703
Phone
(414) 607-4100
NPI assigned
Mar 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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

Authorized official

Name
Mr. James Enlund
Title
President & Ceo
Phone
(414) 607-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NA-CBRF WI Primary

Addresses

Primary practice location

3023 S 84TH St
West Allis, WI 53227-3703

Mailing address

3023 S 84TH St
West Allis, WI 53227-3703
Phone (414) 607-4100

Other identifiers 1

IdentifierTypeStateIssuer
2013000MedicaidWI

Other names 1

  • Palmer House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Methodist Manor Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1649247453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 S 84TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532273703",
            "telephone_number": "414-607-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 S 84TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532273703",
            "telephone_number": "414-607-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "ENLUND",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "414-607-4101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "NA-CBRF",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmer House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Allis, WI

Sources for this page

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