Green Bay Rehabilitation Hospital LLC

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

Legal business name

GREEN BAY REHABILITATION HOSPITAL LLC

Practice address

1110 Kepler Drive
Green Bay, WI 54311-8321

Phone

(920) 304-9695

NPI assigned

Aug 4, 2022

Organization subpart

No

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

Authorized official

Name

Denise Kann

Title

Vice President and Secretary

Phone

(972) 216-2299

Specialties & licenses 1

Addresses

Other names 1

• Green Bay Rehabilitation Hospital Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Hospital certification: CCN 523031

Legal name

GREEN BAY REHABILITATION HOSPITAL LLC

Doing business as

GREEN BAY REHABILITATION HOSPITAL

Certification status

Active

Provider type (POS)

Hospital – Rehabilitation

Participating since

May 5, 2023

Last certification

May 5, 2023

Beds

40

Ownership / control type

Private (for profit)

Organization structure

LLCProprietary

Incorporated

Nov 22, 2017 in DE

Enrollment address

1110 Kepler Dr
Green Bay, WI 54311-8321
Main/Primary Hospital Location

Hospital subgroups

Rehabilitation

Listed as

Green Bay Rehabilitation HospitalCCN 523031

Ownership

For profit

Certified

May 5, 2023

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Facilities with the same owner 40

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Advanced Care Hospital of Montana Inc

  • Long Term Care Hospital
  • Billings, MT
  • NPI 1356536312

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Advanced Care Hospital of Montana Inc

  • Rehabilitation Hospital
  • Billings, MT
  • NPI 1639991540

  Epoch Acquisition Inc, Epoch Midco Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Advanced Care Hospital of Northern Colorado LLC

  • Long Term Care Hospital
  • Johnstown, CO
  • NPI 1598830267

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Advanced Care Hospital of Southern New Mexico LLC

  • Long Term Care Hospital
  • Las Cruces, NM
  • NPI 1083787345

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Bakersfield Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Bakersfield, CA
  • NPI 1033780556

  Epoch Acquisition Inc, Epoch Midco Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Bloomington Regional Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Bloomington, IN
  • NPI 1770159022

  Epoch Acquisition Inc, Epoch Midco Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Corpus Christi Rehabilitation Hospital LLC

  • Rehabilitation Hospital
  • Corpus Christi, TX
  • NPI 1821439183

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Covenant Rehabilitation Hospital of Lubbock LLC

  • Rehabilitation Hospital
  • Lubbock, TX
  • NPI 1952784985

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Denver Regional Rehabilitation Hospital LLC

  • Rehabilitation Hospital
  • Thornton, CO
  • NPI 1407375249

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Elkhorn Valley Rehabilitation Hospital LLC

  • Rehabilitation Hospital
  • Casper, WY
  • NPI 1326233586

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Greenwood Regional Rehabilitation Hospital LLC

  • Skilled Nursing Facility
  • Greenwood, SC
  • NPI 1457573875

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership
• Greenwood Regional Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Greenwood, SC
  • NPI 1861614224

  Epoch Acquisition Inc, Epoch Parent Holdings LLC, Epoch Parent Inc, Ernest Health Holdings LLC, One Equity Partners VII LP, One Equity Partners VII-a LP, One Equity Partners VII-B LP

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Elizabeth Anne Polacheck, MD

  • Physical Medicine & Rehabilitation Physician
  • Green Bay, WI
  • NPI 1528115250

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1902533474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 N GALLOWAY AVE STE 102",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492434",
            "telephone_number": "972-216-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 KEPLER DRIVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118321",
            "telephone_number": "920-304-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN BAY REHABILITATION HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "KANN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "VICE PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "972-216-2299"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequesst_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMd eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Green Bay Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Green Bay Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rehabilitation Hospital in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Rehabilitation Hospital in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.