Iconicare of Mequon, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ICONICARE OF MEQUON, LLC

Practice address

6751 W Mequon Rd
Mequon, WI 53092-1836

Phone

(262) 512-8060

NPI assigned

Sep 20, 2019

Organization subpart

No

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

Authorized official

Name

Tricia Lies

Title

Director of Financial Services

Phone

(952) 888-2923

Specialties & licenses 1

Addresses

Other names 1

• Wright Senior Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1780235804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6751 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921836",
            "telephone_number": "262-512-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6751 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921836",
            "telephone_number": "262-512-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICONICARE OF MEQUON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "LIES",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCIAL SERVICES",
        "authorized_official_telephone_number": "952-888-2923"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wright Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Janet Susan Ingold, PTA
• Inspired Senior Living of Mequon Mt, LLC

• Assisted Living Facility in Mequon, WI
• Providers in Mequon, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.