Five Star Quality Care Wi LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3059 Issued in WI

Legal business name

FIVE STAR QUALITY CARE WI LLC

Practice address

1451 Cleveland Ave
Waukesha, WI 53186-3876

Phone

(262) 547-2123

Fax

(262) 547-6204

NPI assigned

May 25, 2006

Organization subpart

Yes

Parent organization

FIVE STAR QUALITY CARE WI LLCAs reported in NPPES

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

Authorized official

Name

Katherine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Virginia Health and Rehabilitation Center Doing business as

Part of

Five Star Quality Care-Wi LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Five Star Quality Care - Wi

  • Assisted Living Facility
  • Madison, WI
  • NPI 1205083185
  NPPES parent name

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1750337705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 CLEVELAND AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863876",
            "telephone_number": "262-547-2123",
            "fax_number": "262-547-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 CLEVELAND AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863876",
            "telephone_number": "262-547-2123",
            "fax_number": "262-547-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR QUALITY CARE WI LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR QUALITY CARE WI LLC",
        "enumeration_date": "2006-05-25",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20187100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virginia Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Virginia Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Sue Fisher, LPC
• Eric Robert Fisher, M.D.
• Kelly Ann Fisher, PA-C
• Claire E Fitzgerald, NP
• Kelly Conley Fitzpatrick, RDH BSDH
• Patrice Flanagan-Morris, LCSW
• Paige Lorraine Flanagan, MS, LPC, NCC, CCTP
• W. Patrick Flanagan Jr., MD
• Nicole Flannery, MS, CSAC, LPC, ICS-I
• Kathryn Ann Flansburg, CSW

• Skilled Nursing Facility in Waukesha, WI
• Providers in Waukesha, 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 Mar 27, 2019; 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.