Organization Active NPI

Lifepulse Wound & Home Healthcare Agency LLC

  • Home Health Agency
  • Racine, WI
National Provider Identifier
1932827029
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LIFEPULSE WOUND & HOME HEALTHCARE AGENCY LLC
Practice address
1100 Commerce Drive
Unit 105
Racine, WI 53406-5340
Phone
(262) 488-5734
NPI assigned
Aug 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Miss Aris M Claybrook, RNNPI 1447876941
Title
Owner
Phone
(262) 488-5734

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1100 Commerce Drive
Unit 105
Racine, WI 53406-5340

Mailing address

1100 Commerce Dr Ste 105
Mt Pleasant, WI 53406-3700
Phone (262) 488-5734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241007003289 WI Part B Supplier - Clinic/Group Practice 0143684555 Receives reassigned benefits from 1 practitioner
Practice locations: Mt Pleasant, WI

National Provider Directory

National Provider Directory

Locations

1516 S Green Bay Rd
Ste 200
Mount Pleasant, WI 53406
Phone (262) 900-1111

1516 S Green Bay Rd
Mount Pleasant, WI 53406
Phone (262) 900-1111

1100 Commerce Dr
Ste 105
Mount Pleasant, WI 53406
Phone (262) 488-5734

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1932827029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 COMMERCE DR STE 105",
            "city": "MT PLEASANT",
            "state": "WI",
            "postal_code": "534063700",
            "telephone_number": "262-488-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 COMMERCE DRIVE",
            "address_2": "UNIT 105",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065340",
            "telephone_number": "262-488-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEPULSE WOUND & HOME HEALTHCARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "CLAYBROOK",
        "authorized_official_first_name": "ARIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-488-5734",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.