PRIVATE DUTY NURSING SERVICE


Address: 1538 Troy Dr Apt 1, Madison, WI 53704-2074
Phone: 2313438538

PRIVATE DUTY NURSING SERVICE (NPI# 1154754620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154754620
Entity Type Organization
Organization Name PRIVATE DUTY NURSING SERVICE
Practice Address 1538 Troy Dr Apt 1
Madison
WI 53704-2074
Practice Telephone 2313438538
Mailing Telephone 2313438538
Enumeration Date 2013-08-19
Last Update Date 2013-08-20
Authorized Official Name MUSTAPHA KAMBI (REGISTERED)
Authorized Official Telephone 2313438538
Authorized Official Credential RN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3140N1450X Skilled Nursing Facility
Specialization: Nursing Care, Pediatric
19433930 WI Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
WI 2241974 05

Office Location

Street Address 1538 TROY DR APT 1
City MADISON
State WI
Zip Code 53704-2074

Providers in the same location

NPI Name Taxonomy Address Enumeration
1881029304 Mustapha Kambi Registered Nurse 1538 Troy Dr Apt 1, Madison, WI 53704-2074 2013-09-04

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Taxonomy Information

Taxonomy Code 3140N1450X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility
Specialization Nursing Care, Pediatric

Taxonomy Definition

A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1154869410 Jacksonscott2 Skilled Nursing Facility 4573 N. 22nd Street, Milwaukee, WI 53209 2017-02-07
1720450125 Independent Nursing Skilled Nursing Facility 143 E Pine Hollow Ln Apt 1, Oak Creek, WI 53154-7714 2015-10-24
1528472024 Colleen L Biller Skilled Nursing Facility 1421 S 17th St, Sheboygan, WI 53081-5123 2014-06-12
1023367612 Johnnie Mae Simmons Skilled Nursing Facility 4560 N. 40th St, Milwaukee, WI 53209 2012-08-29
1629302872 Ashley Zimdahl Skilled Nursing Facility N2364 Sunset Dr, Campbellsport, WI 53010-2038 2009-09-21
1760634729 Regina Angela Lanza Skilled Nursing Facility W193s7842 Overlook Bay Rd # 6d, Muskego, WI 53150-7813 2008-10-21
1881865012 Lisa Salaway Skilled Nursing Facility 510 Cabrillo Ct, Verona, WI 53593-8233 2008-03-16
1538353982 Wisconsin Medicaid Skilled Nursing Facility 1528 Remington Rd, Neenah, WI 54956-1696 2007-08-29
1336340561 Badgerland Billing LLC Skilled Nursing Facility 2632 Smithfield Dr, Fitchburg, WI 53719-1665 2007-05-28
1356303101 Jeannette Ponder Skilled Nursing Facility 3152 N 24th Pl, Milwaukee, WI 53206-1209 2006-04-06
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Competitor

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City MADISON
Zip Code 53704

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Dataset Information

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.

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