FMG New Pine Drive Wisconsin LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG NEW PINE DRIVE WISCONSIN LLC

Doing business as

Oakwood Villa

Practice address

2512 New Pine Dr
Altoona, WI 54720-1378

Phone

(715) 833-0400

Fax

(715) 833-0546

NPI assigned

Jan 16, 2015

Organization subpart

No

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

Authorized official

Name

David Keating

Title

Authorized Official

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Oakwood Villa Doing business as

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1740679547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 NEW PINE DR",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547201378",
            "telephone_number": "715-833-0400",
            "fax_number": "715-833-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 NEW PINE DR",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547201378",
            "telephone_number": "715-833-0400",
            "fax_number": "715-833-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG NEW PINE DRIVE WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakwood Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Extendicare Homes, Inc.
• Favor Thanks
• Judith Ann Ferber, MASSAGE THERAPIST
• Nancy Ferrara-France, FNP
• Lindsey L Field
• Angela Marie Fontanini-Axelrod, PH.D.
• Kyle France
• Frie Optometry LLC
• Natalee Z Frie, O.D.
• Functions LLC

• Skilled Nursing Facility in Altoona, WI
• Providers in Altoona, 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 Jan 16, 2015; 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.