Plymouth Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3169 Issued in WI

Legal business name

PLYMOUTH CARE CENTER LLC

Doing business as

D/B/a Atrium Post Acute Care of Plymouth

Practice address

916 E Clifford St
Plymouth, WI 53073-2438

Phone

(920) 893-4777

Fax

(920) 893-2470

NPI assigned

Aug 23, 2005

Last updated

May 27, 2015By 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

Robert M Parkins

Title

President

Phone

(920) 364-9754

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• D/B/A ATRIUM POST ACUTE CARE OF PLYMOUTH Doing business as

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1952394124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549112444",
            "telephone_number": "920-991-9072",
            "fax_number": "920-749-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 E CLIFFORD ST",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530732438",
            "telephone_number": "920-893-4777",
            "fax_number": "920-893-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "PARKINS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-364-9754"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20193700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D/B/A ATRIUM POST ACUTE CARE OF PLYMOUTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mauricio E Palencia, MD
• Christopher J Parker, PHARM D
• Sandra J Perronne, OT
• Scott R Peschke, MD
• Plymouth Ambulance Service, Inc (Plymouth Ambulance Service)
• Plymouth Chiropractic, SC
• Plymouth Family Physicians, S.C.
• Plymouth Joint School District
• Ashlyn Prisinger, PT
• Dawn H.S. Reinemann, PHD

• Skilled Nursing Facility in Plymouth, WI
• Providers in Plymouth, 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 May 27, 2015; 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.