Organization Active NPI

Lifecare Hospital of Wisconsin

  • Special Hospital
  • Pewaukee, WI
National Provider Identifier
1790963411
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
Legal business name
LIFECARE HOSPITAL OF WISCONSIN
Practice address
2400 Golf Rd
Pewaukee, WI 53072-5590
Phone
(262) 524-2624
NPI assigned
Feb 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Ms. Christie Lynne Schultz, RD, CD, CNSD
Title
Dietitian
Phone
(262) 524-2624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X Primary

Addresses

Primary practice location

2400 Golf Rd
Pewaukee, WI 53072-5590

Mailing address

2400 Golf Rd
Pewaukee, WI 53072-5590

Other identifiers 1

IdentifierTypeStateIssuer
11023900MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1790963411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 GOLF RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 GOLF RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725590",
            "telephone_number": "262-524-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE HOSPITAL OF WISCONSIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "262-524-2624",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD, CD, CNSD"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11023900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.