NPIMap

Organization Active NPI

Racine County

  • Skilled Nursing Facility
  • Racine, WI
National Provider Identifier
1649275991
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2925 Issued in WI
Legal business name
RACINE COUNTY
Practice address
3205 Wood Rd
Racine, WI 53406-5048
Phone
(262) 554-6440
Fax
(262) 554-5119
NPI assigned
Jun 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Authorized official

Name
Mr. William L McReynolds
Title
County Executive
Phone
(262) 636-3273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2925 WI Primary

Addresses

Primary practice location

3205 Wood Rd
Racine, WI 53406-5048

Mailing address

3205 Wood Rd
Racine, WI 53406-5048
Phone (262) 554-6440

Other identifiers 1

IdentifierTypeStateIssuer
20130700MedicaidWI

Other names 1

  • Ridgewood Care Center Other name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3205 Wood Rd
Racine, WI 53406
Phone (262) 554-6440

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1649275991",
    "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": "262-554-6440",
            "fax_number": "262-554-5119"
        },
        {
            "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": "262-554-6440",
            "fax_number": "262-554-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACINE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "MCREYNOLDS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COUNTY EXECUTIVE",
        "authorized_official_telephone_number": "262-636-3273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20130700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgewood Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 14, 2008; 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.