Rhinelander Healthcare Operator 150 LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RHINELANDER HEALTHCARE OPERATOR 150 LLC

Doing business as

Friendly Village Nursing and Rehabilitation Center

Practice address

900 Boyce Dr
Rhinelander, WI 54501-3835

Phone

(715) 365-6832

Fax

(715) 365-6665

NPI assigned

May 5, 2006

Last updated

Dec 30, 2014By 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

Mr. Stacey Paul Rogers

Title

Chief Financial Officer

Phone

(502) 429-8062

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Friendly Village Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1932157526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 NEW LA GRANGE RD",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224870",
            "telephone_number": "502-429-8062",
            "fax_number": "502-429-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BOYCE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545013835",
            "telephone_number": "715-365-6832",
            "fax_number": "715-365-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHINELANDER HEALTHCARE OPERATOR 150 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "502-429-8062",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20197400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendly Village Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.