NPIMap

Organization Active NPI

SSM Health Care of Wisconsin, Inc.

Doing business as St. Clare Meadows Care Center

  • Skilled Nursing Facility
  • Baraboo, WI
National Provider Identifier
1922067636
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
3099 Issued in WI
Legal business name
SSM HEALTH CARE OF WISCONSIN, INC.
Doing business as
St. Clare Meadows Care Center
Practice address
1414 Jefferson St
Baraboo, WI 53913-1503
Phone
(608) 356-4838
Fax
(608) 356-5441
NPI assigned
Mar 21, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. CLARE MEADOWS CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Ronnie E Schaetzl
Title
Administrator
Phone
(608) 356-4838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 3099 WI Primary

Addresses

Primary practice location

1414 Jefferson St
Baraboo, WI 53913-1503

Mailing address

1414 Jefferson St
Baraboo, WI 53913-1503
Phone (608) 356-4838

Other identifiers 6

IdentifierTypeStateIssuer
20184400MedicaidWI
647552OtherCOMBINED INSURANCE CO OF
391023846539130001OtherWPS TRICARE FOR LIFE
39117860200OtherUNITY/COMMUNITY HMO
391023846036OtherBLUE CROSS BLUE SHIELD WI
556910OtherDEAN HEALTH PLAN

Other names 1

  • St. Clare Meadows Care Center Doing business as

National Provider Directory

National Provider Directory
Part of
Rocco J Fiordelisi MD

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1922067636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 JEFFERSON ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131503",
            "telephone_number": "608-356-4838",
            "fax_number": "608-356-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 JEFFERSON ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131503",
            "telephone_number": "608-356-4838",
            "fax_number": "608-356-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF WISCONSIN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. CLARE MEADOWS CARE CENTER",
        "enumeration_date": "2006-03-21",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SCHAETZL",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "608-356-4838"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20184400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMBINED INSURANCE CO OF",
            "identifier": "647552",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE FOR LIFE",
            "identifier": "391023846539130001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITY/COMMUNITY HMO",
            "identifier": "39117860200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD WI",
            "identifier": "391023846036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "556910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Clare Meadows Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baraboo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.