NPIMap

Organization Active NPI

Milwaukee Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Milwaukee, WI
National Provider Identifier
1689209140
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
MILWAUKEE REHABILITATION HOSPITAL, LLC
Practice address
3200 S 103Rd St
Milwaukee, WI 53227-4104
Phone
(469) 640-6503
NPI assigned
Mar 5, 2020
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Tracey Michelle Nixon
Title
Chief Compliance Officer
Phone
(469) 640-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

3200 S 103Rd St
Milwaukee, WI 53227-4104

Mailing address

450 Century Pkwy Ste 220
Allen, TX 75013-8135
Phone (469) 640-6503

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211027002721 WI Part A Provider - Hospital 1850789637 Practice locations: Milwaukee, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689209140. Details of each certification follow.

Hospital certification: CCN 523029

Legal name
MILWAUKEE REHABILITATION HOSPITAL, LLC
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Mar 10, 2022
Last certification
Mar 10, 2022
Beds
40
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Feb 12, 2020 in DE
Enrollment address
3200 S 103Rd St
Milwaukee, WI 53227-4104
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Milwaukee Rehabilitation Hospital at GreenfieldCCN 523029 · All quality measures
Ownership
For profit
Certified
Mar 10, 2022
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2241553Milwaukee Rehabilitation Hospital, LLC3200 S 103Rd St, Milwaukee, WI 53227Certificate of waiverOct 28, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jerry B Eady Individual W-2 Managing EmployeeAd; Apr 21, 2025
Tracey Nixon Individual Corporate OfficerChief Compliance Officer Oct 1, 2021
Nepi, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2021 6%
Daryn Eudaly Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2021 27.21%
Alex Bennett Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2021 8.39%
Nesi, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2021 6%
New Era Companies, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2021 54.42%
WB Development Holdings, LLC Organization, Dallas, TX LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2021 33.58%
Nobis Rehabilitation Partners, LLC Organization, Lucas, TX LLC Operational/Managerial Control Oct 1, 2021 100%
Newera Nobis Operations Holdings, LLC Organization, Grapevine, TX LLC 5% Or Greater Direct Ownership Interest Oct 1, 2021 100%
Nobis Hospital Investments, LLC Organization, Lucas, TX LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2021 6%
Ahac Investments, LLC Organization, Irving, TX LLC 5% Or Greater Indirect Ownership Interest Oct 26, 2021 8.39%
Newera Irf Holdings, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2021 100%
Karen Macy Schepis Individual Corporate DirectorCorporate Director of Compliance Jul 28, 2025
Margie Crawley Individual Corporate DirectorCorporate Director of Revenue Cycle Jul 28, 2025
Chester W Crouch Individual Corporate OfficerChief Executive Officer Oct 1, 2021
Irf JV Investors, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2021 6%

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1689209140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CENTURY PKWY STE 220",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750138135",
            "telephone_number": "469-640-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S 103RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274104",
            "telephone_number": "469-640-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKEE REHABILITATION HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-05",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "469-640-6500"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.