NPIMap

Organization Active NPI

Methodist Manor of Waukesha, Inc.

  • Inpatient Hospice
  • West Allis, WI
National Provider Identifier
1750359220
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient HospiceTaxonomy code 315D00000X
License
2002 Issued in WI
Legal business name
METHODIST MANOR OF WAUKESHA, INC.
Practice address
8300 W Beloit Rd
West Allis, WI 53219-2412
Phone
(414) 607-4451
Fax
(414) 607-4459
NPI assigned
Mar 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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

Authorized official

Name
Mr. James Enlund
Title
President & Ceo
Phone
(414) 607-4100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2002 WI
Inpatient Hospice 315D00000X 2002 WI Primary
Respite Care 385H00000X 2002 WI

Addresses

Primary practice location

8300 W Beloit Rd
West Allis, WI 53219-2412

Mailing address

3023 S 84TH St
West Allis, WI 53227-3703
Phone (414) 607-4100

Other identifiers 2

IdentifierTypeStateIssuer
43190000MedicaidWI
2002OtherWIFACILITY LICENSE NUMBER

Other names 1

  • Ruth Hospice Doing business as

National Provider Directory

National Provider Directory

Locations

8300 W Beloit Rd
West Allis, WI 53219
Phone (414) 607-4451

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1750359220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 S 84TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532273703",
            "telephone_number": "414-607-4100",
            "fax_number": "414-607-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 W BELOIT RD",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532192412",
            "telephone_number": "414-607-4451",
            "fax_number": "414-607-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MANOR OF WAUKESHA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "ENLUND",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "414-607-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WI",
            "license": "2002",
            "primary": false
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "WI",
            "license": "2002",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "WI",
            "license": "2002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43190000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE NUMBER",
            "identifier": "2002",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ruth Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.