Five Star Quality Care Wi LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3058 Issued in WI

Legal business name

FIVE STAR QUALITY CARE WI LLC

Practice address

321 Riverside Dr
Pewaukee, WI 53072-4612

Phone

(262) 691-2300

Fax

(262) 691-2184

NPI assigned

May 24, 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

Bruce J. Mackey Jr.

Title

President & Chief Executive Officer

Phone

(617) 796-8214

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• River Hills West Health Care Center Doing business as

Part of

Five Star Quality Care-Wi LLC

Locations

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461283200000",
    "number": "1770538134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 RIVERSIDE DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724612",
            "telephone_number": "262-691-2300",
            "fax_number": "262-691-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 RIVERSIDE DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724612",
            "telephone_number": "262-691-2300",
            "fax_number": "262-691-2184"
        }
    ],
    "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": "2006-05-24",
        "last_updated": "2016-04-22",
        "status": "A",
        "authorized_official_last_name": "MACKEY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8214",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20186900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Hills West Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Pewaukee, WI
• Providers in Pewaukee, 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 Apr 22, 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.