WILLOW RIDGE HEALTHCARE FACILITIES, LLC (NPI# 1275689903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275689903 |
| Entity Type | Organization |
| Organization Name | WILLOW RIDGE HEALTHCARE FACILITIES, LLC |
| Other Organization Name | WILLOW RIDGE |
| Practice Address |
400 Deronda St Amery WI 54001-1404 |
| Practice Telephone | 7152688171 |
| Mailing Telephone | 7152688171 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAWN M. MARSH (VICE PRESIDENT OPERATIONS) |
| Authorized Official Telephone | 6082252516 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2642 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20186400 | 05 |
| Other Name | Type Code |
|---|---|
| Willow Ridge | Doing Business As Name - Organization |
| Street Address |
400 DERONDA ST |
| City | AMERY |
| State | WI |
| Zip Code | 54001-1404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033584545 | Luke Grosskreutz | Physical Therapist | 400 Deronda St, Amery, WI 54001-1404 | 2015-12-09 |
| 1093989253 | Christine Boden Davis | Occupational Therapist | 400 Deronda St, Amery, WI 54001-1404 | 2008-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124313424 | Heather Rose Marks | Dentist | 1030 Riverplace Drive, Amery, WI 54001 | 2011-06-14 |
| 1003142803 | Linda Christine Mueller | Counselor | 236 Griffin, Amery, WI 54001 | 2009-10-29 |
| 1952538548 | Samantha E. Kealey | Emergency Medicine | 265 Griffin St. E., Amery, WI 54001 | 2009-06-22 |
| 1578753448 | Bethann M Monson | Occupational Therapy Assistant | 220 N Keller Avene, Amery, WI 54001 | 2007-07-27 |
| 1912109851 | Jill R. Ladwig | Physical Therapy Assistant | 220 Keller Avenue, Amery, WI 54001 | 2007-06-04 |
| 1376601674 | Nancy A Reinhardt | Occupational Therapist | 505 Keller Ave S, Amery, WI 54001 | 2006-12-05 |
| 1093873390 | Jessica L Bradford | Occupational Therapist | 505 Keller Ave Sq, Amery, WI 54001 | 2006-12-05 |
| 1548354244 | A Touch of Life Inc. | Chiropractor | 308 North Keller Avenue, Amery, WI 54001 | 2006-10-03 |
| 1568566057 | Douglas D Podoll Dds Dc | Dentist | 404 Wisconsin Ave, Amery, WI 54001 | 2006-09-12 |
| 1275928616 | Maria Finke | Emergency Medicine | 265 Griffin St E, Amery, WI 54001 | 2015-04-02 |
| Find all providers in zip 54001 | ||||
| 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 |
|---|---|---|---|---|
| 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.