Heartland-Pewauke of Waukesha Wi LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3248 Issued in WI

Legal business name

HEARTLAND-PEWAUKE OF WAUKESHA WI LLC

Doing business as

ManorCare Health Services-Pewaukee

Practice address

N26W23977 Watertown Rd
Waukesha, WI 53188-1006

Phone

(262) 523-0933

Fax

(262) 523-1674

NPI assigned

May 27, 2006

Last updated

Feb 26, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ManorCare Health Services-Pewaukee Doing business as

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1770530891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5734",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N26W23977 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881006",
            "telephone_number": "262-523-0933",
            "fax_number": "262-523-1674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND-PEWAUKE OF WAUKESHA WI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20199600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ManorCare Health Services-Pewaukee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Jo Hazelwood, MS, LAT
• Greg Heal, M.D.
• Health Center Pharmacy of Menomonee Falls (Health Center Pharmacy-West)
• Healthstat Onsite Clinic- Waukesa
• Hearing Center, Inc.
• Michelle Kathryn Heaton, D.O.
• Amanda Hebard
• Karen Heckel, DNP, AGACNP-BC
• Heffernan Chiropractic Clinic SC
• Amy Lynne Heffernan

• 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 Feb 26, 2016; 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.