Individual provider Active NPI

Jenna N Maliszewski

  • Skilled Nursing Facility
  • Milwaukee, WI
National Provider Identifier
1659669349
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5052026 Issued in WI
Practice address
3540 S 43Rd St
Milwaukee, WI 53220-1502
Phone
(414) 541-1000
Fax
(414) 328-2159
NPI assigned
Jul 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5052026 WI Primary

Addresses

Primary practice location

3540 S 43Rd St
Milwaukee, WI 53220-1502

Mailing address

3540 S 43Rd St
Milwaukee, WI 53220-1502
Phone (414) 541-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5052026WIMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1659669349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 S 43RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532201502",
            "telephone_number": "414-541-1000",
            "fax_number": "414-328-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 S 43RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532201502",
            "telephone_number": "414-541-1000",
            "fax_number": "414-328-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALISZEWSKI",
        "first_name": "JENNA",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "5052026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.