NPIMap

Organization Active NPI

Kindred Healthcare

  • Skilled Nursing Facility
  • Neenah, WI
National Provider Identifier
1891961512
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
KINDRED HEALTHCARE
Practice address
125 Byrd Ave
Neenah, WI 54956-4015
Phone
(920) 725-7869
Fax
(920) 722-9932
NPI assigned
May 2, 2008
Last updated
May 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Miss Elda Edith Martinez, COTA
Title
Occupational Therapy Assistant
Phone
(920) 725-7869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

125 Byrd Ave
Neenah, WI 54956-4015

Mailing address

125 Byrd Ave
Neenah, WI 54956-4015
Phone (920) 725-7869

Other identifiers 1

IdentifierTypeStateIssuer
41037600MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Kindred Nursing Centers Limited Partnership5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1891961512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BYRD AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564015",
            "telephone_number": "920-725-7869",
            "fax_number": "920-722-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BYRD AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564015",
            "telephone_number": "920-725-7869",
            "fax_number": "920-722-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ELDA",
        "authorized_official_middle_name": "EDITH",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPY ASSISTANT",
        "authorized_official_telephone_number": "920-725-7869",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41037600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.