Bornemann Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BORNEMANN NURSING HOME INC

Practice address

226 Bornemann St
Green Bay, WI 54302

Phone

(920) 468-8675

Fax

(920) 468-0667

NPI assigned

Aug 31, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Bonnie J Davis

Title

Nha Owner

Phone

(920) 468-8675

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851385231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 BORNEMANN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54302",
            "telephone_number": "920-468-8675",
            "fax_number": "920-468-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 BORNEMANN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54302",
            "telephone_number": "920-468-8675",
            "fax_number": "920-468-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORNEMANN NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NHA OWNER",
        "authorized_official_telephone_number": "920-468-8675",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20163500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradford Paul Bordini, LCSW
• Carolyn Margaret Bores, DDS
• Cori E Borg, APNP
• Jeanne Louise Borgen, CRNA
• Jesse Jon Borman, MD
• Bornemann Operating Company, LLC
• Wayne Borowitz, SAC-IT
• Heather A Bors
• Gail P Bosco, PA
• John J. Bosco, M.D.

• Skilled Nursing Facility in Green Bay, WI
• Providers in Green Bay, 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 Aug 22, 2020; 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.