LJ III Health Management Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3061 Issued in WI

Legal business name

LJ III HEALTH MANAGEMENT INC.

Doing business as

Premier Rehabilitation & Skilled Nursing

Practice address

2121 Pioneer Dr
Beloit, WI 53511-3025

Phone

(608) 365-9526

Fax

(608) 365-9761

NPI assigned

Jun 16, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lee Gunderson

Title

Administrator

Phone

(608) 365-9526

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Premier Rehabilitation & Skilled Nursing Doing business as

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669477659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 PIONEER DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113025",
            "telephone_number": "608-365-9526",
            "fax_number": "608-365-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 PIONEER DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113025",
            "telephone_number": "608-365-9526",
            "fax_number": "608-365-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LJ III HEALTH MANAGEMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUNDERSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "608-365-9526",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20185800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Rehabilitation & Skilled Nursing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Linek
• Jaclyn Lineman, PHARMD
• Marek J Lisek, D.O.
• Thomas J Lisk, MD
• John Peder Littlefield, P.A.
• Janice Loesel, DENTAL HYGIENIST
• Kerilynn Loftus, MD
• Pamela C Long
• Caitlyn Loth, LMFT- INTERN
• Kelly N Lovejoy, PA-C

• Skilled Nursing Facility in Beloit, WI
• Providers in Beloit, 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 Aug 22, 2020; 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.