GL Healthcare

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

963-019 Issued in WI

Legal business name

GL HEALTHCARE

Practice address

470 Garfield Ave
Evansville, WI 53536-1014

Phone

(608) 882-6557

Fax

(608) 882-6559

NPI assigned

Aug 5, 2007

Last updated

Aug 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ilene Larson, PTNPI 1528122009

Title

Owner

Phone

(608) 223-1452

Specialties & licenses 1

Addresses

Tax ID family

GL Healthcare2 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.

• GL Rehabilitation Services LTD

  • Physical Therapist
  • Evansville, WI
  • NPI 1205880879
  NPD tax ID

Practitioners 1

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.

• Ilene Linda Larson, PHYSICAL THERAPIST

  • Physical Therapist
  • Madison, WI
  • NPI 1528122009
  NPD Authorized official

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1891986964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 WAUNONA WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131525",
            "telephone_number": "608-223-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 GARFIELD AVE",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361014",
            "telephone_number": "608-882-6557",
            "fax_number": "608-882-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "ILENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-223-1452",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "963-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Frikken, DPT
• Maria Fernanda Ganoung
• Monique Gentry, RN
• Justin George, PTA
• John C Gernetzke, D.D.S.
• GL Rehabilitation Services LTD
• Emily Anna Gorces, BSN, RN
• Grand Line Dentistry
• Elizabeth Nicole Halson, APNP
• Cali Hensel, DDS

• Skilled Nursing Facility in Evansville, WI
• Providers in Evansville, 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 5, 2007; 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.