FMG 26TH Avenue Wisconsin LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG 26TH AVENUE WISCONSIN LLC

Practice address

516 26TH Ave
Monroe, WI 53566-1531

Phone

(608) 325-9141

Fax

(608) 329-6594

NPI assigned

Jan 22, 2015

Organization subpart

No

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

Authorized official

Name

David Keating

Title

Authorized Official

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Monroe Manor Nursing & Rehabilitation Doing business as

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1851780290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 26TH AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661531",
            "telephone_number": "608-325-9141",
            "fax_number": "608-329-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 26TH AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661531",
            "telephone_number": "608-325-9141",
            "fax_number": "608-329-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG 26TH AVENUE WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monroe Manor Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharon M Farrey, LCSW
• Michelle S. Faull, DO
• Becky M Fenn, OT
• Shawn Patrick Ferguson, RPH
• Alicia Ann Fishlock, MSW, CAPSW, CSAC
• Meredith Nicole Foley, OTR/L
• Jaclyn M Foltz, OTR/L
• Kristine E. Fosler, APNP
• Raven Foulker Flannery, APNP
• Fowler Memorial Free Dental Clinic

• Skilled Nursing Facility in Monroe, WI
• Providers in Monroe, 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 Jan 22, 2015; 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.