NPIMap

Organization Active NPI

Greenfield Rehabilitation Agency, Inc.

  • Physical Therapist
  • Brookfield, WI
National Provider Identifier
1811907462
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GREENFIELD REHABILITATION AGENCY, INC.
Practice address
3360 Gateway Rd Ste 100
Brookfield, WI 53045-5115
Phone
(262) 923-7178
Fax
(262) 923-7178
NPI assigned
Aug 8, 2006
Last updated
Jan 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Katherine A Brewer, PT, MBA, GCS, RAC-CTNPI 1417163551
Title
President/Owner
Phone
(262) 923-7101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

3360 Gateway Rd Ste 100
Brookfield, WI 53045-5115

Mailing address

3360 Gateway Rd Ste 100
Brookfield, WI 53045-5115
Phone (262) 923-7101

Other identifiers 1

IdentifierTypeStateIssuer
41805600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050328000053 WI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4082660667 Practice locations: Green Bay, WI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Greenfield Rehabilitation Agency2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baird TrustBrookfield, WI, CCN 525700 Skilled nursing facility Operational/Managerial Control Jul 1, 2019
Woodside Lutheran HomeGreen Bay, WI, CCN 525557 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2019
Apr 30, 2026

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1811907462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 GATEWAY RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455115",
            "telephone_number": "262-923-7101",
            "fax_number": "262-923-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 GATEWAY RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455115",
            "telephone_number": "262-923-7178",
            "fax_number": "262-923-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENFIELD REHABILITATION AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "262-923-7101",
        "authorized_official_credential": "PT, MBA, GCS, RAC-CT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41805600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.