STATE OF WISCONSIN (NPI# 1235225616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235225616 |
| Entity Type | Organization |
| Organization Name | STATE OF WISCONSIN |
| Other Organization Name | NORTHERN WISCONSIN CENTER EXCEL |
| Practice Address |
2820 East Park Avenue Chippewa Falls WI 54729-0340 |
| Practice Telephone | 7157235542 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. LOUISE E RAMSELER (INSTITUTION SUPERINTENDENT) |
| Authorized Official Telephone | 7157235542 |
| Authorized Official Credential | NHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 2753 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 21050200 | 05 |
| Other Name | Type Code |
|---|---|
| Northern Wisconsin Center Excel | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558615815 | State of Wisconsin | Skilled Nursing Facility | 2175 E Park Ave, Chippewa Falls, WI 54729-3511 | 2012-11-07 |
| 1225152861 | State of Wisconsin | Skilled Nursing Facility | 21425g Spring St, Union Grove, WI 53182-9707 | 2007-03-19 |
| 1366439986 | State of Wisconsin | Skilled Nursing Facility | N2665 County Road Qq, King, WI 54946 | 2005-09-29 |
| 1225362403 | State of Wisconsin | Durable Medical Equipment & Medical Supplies | 317 Knutson Dr, Madison, WI 53704-1133 | 2009-09-22 |
| 1336324946 | State of Wisconsin | Intermediate Care Facility, Mentally Retarded | 317 Knutson Dr, Madison, WI 53704-1133 | 2008-01-02 |
| 1588703078 | State of Wisconsin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 317 Knutson Dr, Madison, WI 53704-1133 | 2007-02-05 |
| 1386705655 | State of Wisconsin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 317 Knutson Dr, Madison, WI 53704-1133 | 2006-12-12 |
| 1164516506 | State of Wisconsin | Psychiatric Hospital | 1300 South Drive, Winnebago, WI 54985-0009 | 2006-10-02 |
| 1437253648 | State of Wisconsin | General Acute Care Hospital | 301 Troy Dr, Madison, WI 53704-1521 | 2006-09-08 |
| 1043326747 | State of Wisconsin | Intermediate Care Facility, Mentally Retarded | 21425 Spring St, Union Grove, WI 53182-9707 | 2006-08-22 |
| Street Address |
2820 EAST PARK AVENUE |
| City | CHIPPEWA FALLS |
| State | WI |
| Zip Code | 54729-0340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669963468 | Stephanie Ann Mclaughlin | Counselor | 345 Frenette Dr Ste 3, Chippewa Falls, WI 54729 | 2018-05-29 |
| 1841613148 | Terri Roberts | Nurse Practitioner | 2661 Cty Hwy I, Chippewa Falls, WI 54729 | 2014-01-23 |
| 1487928792 | Angela Marie Halbert | In Home Supportive Care | 5545 165th St, Chippewa Falls, WI 54729 | 2012-03-05 |
| 1679869739 | Furniture Loft, Inc. | Durable Medical Equipment & Medical Supplies | 1849 County Highway Oo, Chippewa Falls, WI 54729 | 2011-06-27 |
| 1184917825 | Joshua Paul Finn | Chiropractor | 17 East Central Street, Chippewa Falls, WI 54729 | 2011-05-26 |
| 1346540978 | St. Joseph's Hospital | Rehabilitation Hospital | 2661 County Road I, Chippewa Falls, WI 54729 | 2010-10-29 |
| 1770819773 | Chippewa Clinic Pharmacy | Pharmacy | 2509 County Hwy I, Chippewa Falls, WI 54729 | 2009-10-26 |
| 1689811853 | Clark Family Dental Inc | Dentist | 777 Park Avenue, Chippewa Falls, WI 54729 | 2009-01-09 |
| 1295995660 | Kelly S Abraham | Licensed Practical Nurse | 400 Pumphouse Rd, Apt #26, Chippewa Falls, WI 54729 | 2008-06-10 |
| 1225296700 | Wellington Hervey Davis Jr. | Registered Nurse | 721 Buttenhoff Rd, Chippewa Falls, WI 54729 | 2008-05-30 |
| Find all providers in zip 54729 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790036739 | United Care Homes of Wisconsin LLC | Intermediate Care Facility, Mentally Retarded | 338 Municipal Dr, West Bend, WI 53095-3510 | 2012-10-01 |
| 1114158029 | Mississippi Valley Health Services Commission | Intermediate Care Facility, Mentally Retarded | 902 Garland St E, West Salem, WI 54669-1308 | 2009-07-28 |
| 1891931085 | The Arc of Columbia County | Intermediate Care Facility, Mentally Retarded | 711 E Cook St, Portage, WI 53901-2300 | 2008-12-18 |
| 1871714543 | St. Coletta of Wisconsin | Intermediate Care Facility, Mentally Retarded | W4955 Us Highway 18, Jefferson, WI 53549-9702 | 2007-05-01 |
| 1841418415 | Mccarthy Nursing Home | Intermediate Care Facility, Mentally Retarded | 124 S Monroe St, Stoughton, WI 53589-2012 | 2007-04-20 |
| 1689890204 | Hoplite, Inc. | Intermediate Care Facility, Mentally Retarded | 1719 Washington Ave, Racine, WI 53403-2019 | 2007-04-18 |
| 1376531061 | Wi Il Senior Housing | Intermediate Care Facility, Mentally Retarded | 1002 Eueka Street, Ripon, WI 54971 | 2005-10-07 |
| 1265429278 | County of Grant - Orchard Manor Fdd | Intermediate Care Facility, Mentally Retarded | 8800 Hwy 61, Lancaster, WI 53813-9306 | 2005-10-04 |
| 1790771368 | Heyde Health System, Inc | Intermediate Care Facility, Mentally Retarded | 14135 150th Ave, Bloomer, WI 54724-4410 | 2005-09-20 |
| 1891781464 | Lakeview Health Center | Intermediate Care Facility, Mentally Retarded | 902 E Garland St, West Salem, WI 54669-1308 | 2005-09-20 |
| Find all providers with the same taxonomy | ||||
| City | CHIPPEWA FALLS |
| Zip Code | 54729 |
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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.