Park Manor, LTD.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3674-026 Issued in WI

Legal business name

PARK MANOR, LTD.

Practice address

250 Lawrence Ave
Park Falls, WI 54552-1431

Phone

(715) 762-2449

NPI assigned

Oct 25, 2005

Organization subpart

No

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

Authorized official

Name

Sharon Schultz

Title

Executive Administrator

Phone

(715) 762-2449

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Park Manor LTD2 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.

• Park Manor, LTD.

  • Skilled Nursing Facility
  • Park Falls, WI
  • NPI 1699762625
  NPD tax ID

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871583443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W 3RD ST",
            "address_2": "P.O. BOX 727",
            "city": "WASHBURN",
            "state": "WI",
            "postal_code": "548919507",
            "telephone_number": "715-492-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 LAWRENCE AVE",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521431",
            "telephone_number": "715-762-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MANOR, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "715-762-2449"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3674-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40838200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Antoinette Novitzke, APNP, RN, NHA
• Jordan Michael Oien, DC
• Park Falls Regional Medical Clinic, S.C.
• Park Manor LTD
• Park Manor, LTD.
• Park Pharmacy Inc (North Central IV)
• Park Pharmacy Inc
• Amy Pearson, MA, PT, CWS
• Mark Steven Pechacek, RPH
• Tennille H. Penn, D.D.S.

• Skilled Nursing Facility in Park Falls, WI
• Providers in Park Falls, 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.