NPIMap

Organization Active NPI

St Paul Elder Services, Inc

  • Adult Day Care Clinic/Center
  • Kaukauna, WI
National Provider Identifier
1821682162
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
ST PAUL ELDER SERVICES, INC
Practice address
316 E 14TH St
Kaukauna, WI 54130-3304
Phone
(920) 766-6020
Fax
(920) 766-9161
NPI assigned
Feb 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Authorized official

Name
Brian Herman
Title
Cfo
Phone
(920) 766-6020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

316 E 14TH St
Kaukauna, WI 54130-3304

Mailing address

316 E 14TH St
Kaukauna, WI 54130-3304
Phone (920) 766-6020

Other identifiers 1

IdentifierTypeStateIssuer
0010491OtherWIADULT DAY CARE CERTIFICATE

Other names 2

  • ST PAUL ELDER SERVICES INC CLUB GABRIEL Doing business as
  • St Paul Elder Services Adult Day Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Paul Elder Services Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1821682162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 E 14TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303304",
            "telephone_number": "920-766-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 E 14TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303304",
            "telephone_number": "920-766-6020",
            "fax_number": "920-766-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PAUL ELDER SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-766-6020"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT DAY CARE CERTIFICATE",
            "identifier": "0010491",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST PAUL ELDER SERVICES INC CLUB GABRIEL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Paul Elder Services Adult Day Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kaukauna, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.