COLONIAL CENTER, LLC (NPI# 1992790075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992790075 |
| Entity Type | Organization |
| Organization Name | COLONIAL CENTER, LLC |
| Other Organization Name | COLONIAL CENTER |
| Practice Address |
702 W Dolf St Colby WI 54421-9604 |
| Mailing Address |
110 Glancy St Ste 114 Goodlettsville TN 37072-2314 |
| Practice Telephone | 7152232352 |
| Practice Fax Number | 8592815150 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2018-10-11 |
| Authorized Official Name | DOUG SMITH (PRESIDENT) |
| Authorized Official Telephone | 6156479004 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 3080 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20191800 | 05 |
| Other Name | Type Code |
|---|---|
| Colonial Center | Doing Business As Name - Organization |
| Street Address |
702 W DOLF ST |
| City | COLBY |
| State | WI |
| Zip Code | 54421-9604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508214891 | Tara Maki | Physical Therapist | 702 W Dolf St, Colby, WI 54421-9604 | 2016-05-27 |
| 1548604689 | Amy Koch | Occupational Therapist | 702 W Dolf St, Colby, WI 54421-9604 | 2013-04-19 |
| 1316111297 | Charles Lee Bauman | Physical Therapist | 702 W Dolf St, Colby, WI 54421-9604 | 2008-04-22 |
| 1568645117 | Karla Kimlicka | Physical Therapy Assistant | 702 W Dolf St, Colby, WI 54421-9604 | 2007-12-06 |
| 1992991756 | Katie Iverson | Speech-Language Pathologist | 702 W Dolf St, Colby, WI 54421-9604 | 2007-09-14 |
| 1326238692 | Michelle Rose Schwarting | Physical Therapist | 702 W Dolf St, Colby, WI 54421-9604 | 2007-08-01 |
| 1659498285 | Michelle L Sislo | Occupational Therapy Assistant | 702 W Dolf St, Colby, WI 54421-9604 | 2007-03-26 |
| 1639297971 | Mary J. Michalski | Speech-Language Pathologist | 702 W Dolf St, Colby, WI 54421-9604 | 2007-03-26 |
| 1407973290 | Francis Jason Dizon Medina | Physical Therapist | 702 W Dolf St, Colby, WI 54421-9604 | 2007-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891838488 | Philip John Carlson | Chiropractor | 205 W Spence Street, Colby, WI 54421 | 2007-02-14 |
| 1730265661 | Sport & Spine Clinic Lp | Clinic/Center | 604b North Division Street, Colby, WI 54421 | 2006-10-31 |
| 1487764635 | George Krieg | Physician Assistant | 111 Dehne Drive, Colby, WI 54421 | 2006-08-30 |
| 1386750826 | Nicole Wittlinger Quarne | Physical Therapist | 120 Dehne Road, Colby, WI 54421 | 2006-08-21 |
| 1063462828 | Chad A Bogdonovich | Physical Therapist | 604b North Division St, Colby, WI 54421 | 2006-05-11 |
| 1104936251 | Tanya Kausch Hoerneman | Family Medicine | 111 Dehne Drive, Colby, WI 54421 | 2006-08-30 |
| 1841300092 | Paul L Writz | Family Medicine | 111 Dehne Drive, Colby, WI 54421 | 2006-08-30 |
| 1619083151 | Heather Vogel | Physical Therapist | 120 Dehne Road, Colby, WI 54421 | 2006-08-21 |
| 1205203197 | Carlson Chiropractic Clinic LLC | Chiropractor | 111 S. First Street, Colby, WI 54421-0026 | 2015-08-26 |
| 1447326392 | Norval Owen Jackson | Dentist | 607 N 2nd St, Colby, WI 54421-0050 | 2006-11-24 |
| Find all providers in zip 54421 | ||||
| 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 |
|---|---|---|---|---|
| 1285824797 | Colby Operator, LLC | Skilled Nursing Facility | 105 E. College Dr., Colby, KS 67701-3701 | 2007-07-31 |
| 1760446777 | Infinia At Colby | Skilled Nursing Facility | 105 E College Dr, Colby, KS 67701-3701 | 2006-04-14 |
| 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.