NPIMap

Organization Active NPI

FMG Mead Avenue Wisconsin LLC

Doing business as Sheboygan Progressive Care

  • Skilled Nursing Facility
  • Sheboygan, WI
National Provider Identifier
1881083228
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FMG MEAD AVENUE WISCONSIN LLC
Doing business as
Sheboygan Progressive Care
Practice address
1902 Mead Ave
Sheboygan, WI 53081-6140
Phone
(920) 458-8333
Fax
(920) 458-3346
NPI assigned
Jan 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1902 Mead Ave
Sheboygan, WI 53081-6140

Mailing address

1902 Mead Ave
Sheboygan, WI 53081-6140
Phone (920) 458-8333

Other names 1

  • Sheboygan Progressive Care Doing business as

National Provider Directory

National Provider Directory

Locations

1902 Mead Ave
Sheboygan, WI 53081
Phone (920) 458-8333

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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": "1881083228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 MEAD AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816140",
            "telephone_number": "920-458-8333",
            "fax_number": "920-458-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 MEAD AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816140",
            "telephone_number": "920-458-8333",
            "fax_number": "920-458-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG MEAD 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": "Sheboygan Progressive Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

  • 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.