LINCOLN VILLAGE CONVALESCENT CENTER – NPI #1215011317
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.

LINCOLN VILLAGE CONVALESCENT CENTER is a skilled nursing facility (SNF) located in RACINE, WI. NPPES has assigned the NPI number 1215011317 to LINCOLN VILLAGE CONVALESCENT CENTER on October 25, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LINCOLN VILLAGE CONVALESCENT CENTER” is a dba name, the actual legal business name for this organization is LINCOLN LUTHERAN HOME OF RACINE INC. The primary taxonomy selected by this provider is 314000000X from the Health Care Provider Taxonomy code set, which is classified as Skilled Nursing Facility.

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LINCOLN VILLAGE CONVALESCENT CENTER below.

NPI Profile for
LINCOLN LUTHERAN HOME OF RACINE INC

NPI Number
1215011317
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LINCOLN LUTHERAN HOME OF RACINE INC
Doing Business As (dba): LINCOLN VILLAGE CONVALESCENT CENTER
Primary location
1700 CA BECKER DRIVE
RACINE, WI 53406
Phone: (262) 637-9751 Fax: (262) 633-3045
Mailing address
2000 DOMANIK DRIVE
RACINE, WI 53404
Phone: (262) 633-0500 Fax: (262) 633-3045
Organization Subpart
No
Authorized Official
JERRY APPLE
CHIEF FINANCIAL OFFICER
Phone: (262) 898-2722
Updated
Identifiers

Identifiers for LINCOLN VILLAGE CONVALESCENT CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI20129400
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
314000000X
- Skilled Nursing Facility (Primary)
WI 2269

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.