FIVE STAR QUALITY CARE WI LLC (NPI# 1649225392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649225392 |
| Entity Type | Organization |
| Organization Name | FIVE STAR QUALITY CARE WI LLC |
| Other Organization Name | PINE MANOR HEALTH CARE CENTER |
| Practice Address |
1625 E Main St Village of Embarrass Clintonville WI 54929-9236 |
| Mailing Address |
400 Centre St Newton MA 02458 |
| Practice Telephone | 7158233135 |
| Practice Fax Number | 7158231313 |
| Mailing Telephone | 6177968387 |
| Mailing Fax Number | 6177968375 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2008-05-19 |
| Authorized Official Name | BRUCE J MACKEY JR. (CEO) |
| Authorized Official Telephone | 6177968387 |
| Is Organization Subpart | Y |
| Parent Organization Name | FIVE STAR QUALITY CARE WI LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 3052 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 21054400 | 05 |
| Other Name | Type Code |
|---|---|
| Pine Manor Health Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518906833 | Five Star Quality Care Wi LLC | Skilled Nursing Facility | 70 Greentree Rd, Clintonville, WI 54929-1009 | 2006-06-05 |
| 1750337705 | Five Star Quality Care Wi LLC | Skilled Nursing Facility | 1451 Cleveland Ave, Waukesha, WI 53186-3876 | 2006-05-25 |
| 1770538134 | Five Star Quality Care Wi LLC | Skilled Nursing Facility | 321 Riverside Dr, Pewaukee, WI 53072-4612 | 2006-05-24 |
| 1487609178 | Five Star Quality Care Wi LLC | Skilled Nursing Facility | 18740 West Bluemound Road, Brookfield, WI 53045-2936 | 2006-05-23 |
| 1033164124 | Five Star Quality Care Wi LLC | Skilled Nursing Facility | 4325 Nakoma Rd, Madison, WI 53711-3706 | 2006-05-24 |
| Street Address |
1625 E MAIN ST VILLAGE OF EMBARRASS |
| City | CLINTONVILLE |
| State | WI |
| Zip Code | 54929-9236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720646151 | Kysa Lyndell Franseen | Speech-Language Pathologist | 1625 E Main St, Clintonville, WI 54929-8407 | 2019-05-31 |
| 1598249013 | Mary Ann Schroeder | Physical Therapy Assistant | 1625 E Main St, Clintonville, WI 54929-8407 | 2018-09-20 |
| 1104242999 | Cloverleaf Healthcare, Inc. | Skilled Nursing Facility | 1625 E Main St, Clintonville, WI 54929 | 2014-03-17 |
| 1316191877 | Joanne Rita Niemuth | Occupational Therapy Assistant | 1625 E Main St, Clintonville, WI 54929-8407 | 2008-11-11 |
| 1235396581 | Julie Kay Radtke | Physical Therapy Assistant | 1625 E Main St, Clintonville, WI 54929-8407 | 2008-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003045402 | Griebenow Eyecare, S.c. | Optometrist | 45 10th St., Clintonville, WI 54929 | 2009-07-07 |
| 1093835266 | William Henry Krueger | Chiropractor | E9180 Golf Club Road, Clintonville, WI 54929 | 2007-03-30 |
| 1255445680 | Leah K. Smejkal | Physical Therapist | 114 E. Greentree Road, Clintonville, WI 54929 | 2006-08-19 |
| 1962422303 | Clintonville Area Ambulance Service | Ambulance | 16 N. Main, Clintonville, WI 54929 | 2006-07-20 |
| 1649225970 | Jill I. Timm | Physical Therapist | 114 E Greentree Road, Clintonville, WI 54929 | 2006-05-24 |
| 1124286406 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 61 Anne St, Clintonville, WI 54929 | 2008-05-23 |
| 1174734289 | Samuel John Buckett | Chiropractor | E9180 Golf Club Road, Clintonville, WI 54929 | 2007-05-24 |
| 1811057961 | Karen Agnete Johnson | Dentist | 112 S Main Street, Clintonville, WI 54929 | 2006-12-11 |
| 1164509154 | Erickson Home Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 8 S Main St, Clintonville, WI 54929 | 2006-11-01 |
| 1952503245 | Erin Ann Schley | Specialist | 70 W Green Tree Rd, Clintonville, WI 54929-1009 | 2007-05-31 |
| Find all providers in zip 54929 | ||||
| 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 |
|---|---|---|---|---|
| 1518906833 | Five Star Quality Care Wi LLC | Skilled Nursing Facility | 70 Greentree Rd, Clintonville, WI 54929-1009 | 2006-06-05 |
| 1811313604 | Wolf River Healthcare, Inc. | Skilled Nursing Facility | 70 W Green Tree Rd, Clintonville, WI 54929-1009 | 2014-03-17 |
| 1104242999 | Cloverleaf Healthcare, Inc. | Skilled Nursing Facility | 1625 E Main St, Clintonville, WI 54929 | 2014-03-17 |
| 1285901546 | Pine Manor Health Care Ctr | Skilled Nursing Facility | 70 W Green Tree Rd, Clintonville, WI 54929-1009 | 2011-11-30 |
| 1174725238 | Five Star Quality Care | Skilled Nursing Facility | 70 Greentree Rd, Clintonville, WI 54929-1009 | 2007-06-01 |
| 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 | ||||
| City | CLINTONVILLE |
| Zip Code | 54929 |
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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.