WISCONSIN ILLINOIS SENIOR HOUSING INC. (NPI# 1043463961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043463961 |
| Entity Type | Organization |
| Organization Name | WISCONSIN ILLINOIS SENIOR HOUSING INC. |
| Other Organization Name | EAST TROY MANOR |
| Practice Address |
3271 North St East Troy WI 53120-1147 |
| Practice Telephone | 2626423995 |
| Practice Fax Number | 2626423930 |
| Mailing Telephone | 2626423995 |
| Mailing Fax Number | 2626423930 |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2020-05-13 |
| Authorized Official Name | MRS. STEPHANIE L. SHERMAN (MEDICARE PROGRAM MONITOR) |
| Authorized Official Telephone | 3039800611 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | WI | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| East Troy Manor | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780673954 | Wisconsin Illinois Senior Housing Inc. | Skilled Nursing Facility | 471 W Terra Cotta Ave, Crystal Lake, IL 60014-3434 | 2005-10-19 |
| 1649264623 | Wisconsin Illinois Senior Housing Inc. | Skilled Nursing Facility | 425 Summit St, Wild Rose, WI 54984-6804 | 2005-09-07 |
| 1134111826 | Wisconsin Illinois Senior Housing Inc. | Skilled Nursing Facility | 645 N. Church St, Elkhorn, WI 53121 | 2005-08-18 |
| 1336141357 | Wisconsin Illinois Senior Housing Inc. | Skilled Nursing Facility | 211 S Curtis St, Lake Geneva, WI 53147-2052 | 2005-08-10 |
| 1659371938 | Wisconsin Illinois Senior Housing Inc. | Assisted Living Facility | 407 N 8th St, Mount Horeb, WI 53572-1872 | 2005-07-28 |
| 1700884020 | Wisconsin Illinois Senior Housing Inc. | Skilled Nursing Facility | 251 Forest Ln, Montello, WI 53949-9380 | 2005-07-11 |
| 1427408202 | Wisconsin Illinois Senior Housing Inc. | Nurse Practitioner | 640 N Broad St, Elkhorn, WI 53121-1124 | 2016-06-13 |
| 1265825483 | Wisconsin Illinois Senior Housing Inc. | Skilled Nursing Facility | 510 1st St, Spooner, WI 54801-1241 | 2015-03-12 |
| 1063756286 | Wisconsin Illinois Senior Housing Inc. | Skilled Nursing Facility | 313 Stoughton Rd, Edgerton, WI 53534-1132 | 2012-11-15 |
| Street Address |
3271 NORTH ST |
| City | EAST TROY |
| State | WI |
| Zip Code | 53120-1147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215934997 | Kiwanis Manor Inc | Skilled Nursing Facility | 3271 North St, East Troy, WI 53120-1147 | 2005-07-07 |
| 1285137505 | Briana Radtke | Physical Therapist | 3271 North St, East Troy, WI 53120-1147 | 2018-03-13 |
| 1811237803 | Tammi Boyer | Occupational Therapy Assistant | 3271 North St, East Troy, WI 53120-1147 | 2013-02-27 |
| 1689970162 | Lauren Christen Fleming | Physical Therapist | 3271 North St, East Troy, WI 53120-1147 | 2011-02-01 |
| 1568782076 | Tammie L Begotka | Occupational Therapist | 3271 North St, East Troy, WI 53120-1147 | 2010-06-07 |
| 1952540767 | Trisha M Peterson | Physical Therapy Assistant | 3271 North St, East Troy, WI 53120-1147 | 2009-02-18 |
| 1437326063 | Sara L Krause | Occupational Therapist | 3271 North St, East Troy, WI 53120-1147 | 2008-05-13 |
| 1750551594 | Kathleen Florence Kendall | Licensed Practical Nurse | 3271 North St, East Troy, WI 53120-1147 | 2008-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508026659 | Thomas Philip Wanezek | Dentist | 3278 Main Street, East Troy, WI 53120 | 2008-06-12 |
| 1043470347 | Christopher Joseph Mantel | Dentist | 2481 Executive Drive, East Troy, WI 53120 | 2008-06-11 |
| 1649337726 | Wanezek Family Dentistry | Dentist | W3278 Main Street, East Troy, WI 53120 | 2007-01-02 |
| 1376607408 | East Troy Family Dental Center Sc | Clinic/Center | 2481 Executive Dr, East Troy, WI 53120 | 2006-12-21 |
| 1215012117 | Laura Lee Sperle | Registered Nurse | N 8015 Nicky Ct, East Troy, WI 53120 | 2006-10-26 |
| 1609091313 | Koskinen Eye Clinic, LLC | Optometrist | 3278 W Main St, Suite B, East Troy, WI 53120 | 2007-04-16 |
| 1386772986 | Tracy Davies | Dentist | 2481 Executive Dr, East Troy, WI 53120 | 2007-03-02 |
| 1063554350 | Gregory A Nyffeler | Dentist | 2481 Executive Dr, East Troy, WI 53120 | 2007-02-13 |
| 1881628295 | Leslie A. Mroch | Registered Nurse | North 9351 Adams Road, East Troy, WI 53120-0103 | 2006-07-10 |
| 1780733477 | Gerald W Koskinen | Optometrist | 3278 W Main St, East Troy, WI 53120-0165 | 2007-01-10 |
| Find all providers in zip 53120 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215934997 | Kiwanis Manor Inc | Skilled Nursing Facility | 3271 North St, East Troy, WI 53120-1147 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962369 | Heritage Assisted Living, LLC | Skilled Nursing Facility | 5020 S 107th St, Greenfield, WI 53228-3267 | 2020-04-30 |
| 1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
| 1831693936 | Golden Years Nursing Home, Inc. | Skilled Nursing Facility | 611 Harmony Dr, Lake Geneva, WI 53147-8800 | 2018-03-22 |
| 1801302732 | Oak Park Place of Janesville, LLC | Skilled Nursing Facility | 700 Myrtle Way, Janesville, WI 53545-9101 | 2017-12-14 |
| 1235674839 | Zachary Rader | Skilled Nursing Facility | 645 N Church St, Elkhorn, WI 53121-2204 | 2017-01-05 |
| 1982155248 | The Bethany-st. Joseph Corporation D/b/a Prairie Pointe Rehab Suites | Skilled Nursing Facility | 286 N. Willson Dr, Altoona, WI 54720 | 2016-10-20 |
| 1316492317 | Darcy Christiansen | Skilled Nursing Facility | 4427 E Pic A Dilly Dr, Janesville, WI 53546-9606 | 2016-08-19 |
| 1366895583 | Jeffrey Alan Weinshrott | Skilled Nursing Facility | 336 Wisconsin Ave, Sheboygan, WI 53081-4183 | 2016-07-22 |
| 1720433378 | Kendra Meyers | Skilled Nursing Facility | 1806 N Hume Ave Apt 4, Marshfield, WI 54449-1677 | 2016-05-02 |
| 1952756991 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 206 North Willson Drive, Altoona, WI 54720 | 2016-04-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.