Pineview Nursing Home

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

2440 Issued in WI

Legal business name

PINEVIEW NURSING HOME

Practice address

400 County Road R
Black River Falls, WI 54615-5129

Phone

(715) 284-5396

Fax

(715) 284-1502

NPI assigned

Sep 20, 2005

Reactivated

Jan 27, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Kyle Deno, NHA

Title

County Clerk

Phone

(715) 284-0268

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PINEVIEW CARE CENTER Doing business as

Member of 1

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

• County of Jackson

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Black River Falls, WI
  • NPI 1801114632

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1689660250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 MAIN ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546151744",
            "telephone_number": "715-284-0268",
            "fax_number": "715-284-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COUNTY ROAD R",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155129",
            "telephone_number": "715-284-5396",
            "fax_number": "715-284-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEVIEW NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2009-01-27",
        "deactivation_date": "2008-04-17",
        "reactivation_date": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "DENO",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "COUNTY CLERK",
        "authorized_official_telephone_number": "715-284-0268",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "WI",
            "license": "2440",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20157000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PINEVIEW CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suchita Hardik Patel
• Jacob Peloquin, OT
• Brenna Ann Peters, DNP
• Danielle Louise Peterson, DDS
• PFHN, LLC
• John Pleugers, M.A. LPC
• Jeffrey K Polzin, M.D.
• Patricia Popp, PTA
• Amy Prindle, P.A.
• Todd S Reich, D.D.S.

• Alzheimer Center (Dementia Center) in Black River Falls, WI
• Providers in Black River Falls, WI by specialty
• Alzheimer Center (Dementia Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.