BV/Mstar Caledonia Tenant, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

BV/MSTAR CALEDONIA TENANT, LLC

Practice address

5737 Erie St
Racine, WI 53402-1970

Phone

(262) 639-6025

Fax

(262) 639-5279

NPI assigned

Oct 23, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Henry James Vaughn

Title

Reimbursement Analyst

Phone

(240) 595-6025

Specialties & licenses 1

Addresses

Other names 1

• The Woods of Caledonia Doing business as

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1851990436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5737 ERIE ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534021970",
            "telephone_number": "262-639-6025",
            "fax_number": "262-639-5279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5737 ERIE ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534021970",
            "telephone_number": "262-639-6025",
            "fax_number": "262-639-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BV/MSTAR CALEDONIA TENANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "REIMBURSEMENT ANALYST",
        "authorized_official_telephone_number": "240-595-6025",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Woods of Caledonia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Joseph Budny
• Anthony John Budzinski, DDS,MS
• Alexandra Buhler, DC
• Stephanie Burks, RN
• Melissa Burrow
• John J. Byrne, M.D.
• Byron Health and Healing Center
• Rudy V. Byron Jr., M.D.
• C & J Transport LLC
• C&Jmedicalllc

• Alzheimer Center (Dementia Center) in Racine, WI
• Providers in Racine, WI by specialty
• Alzheimer Center (Dementia Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.