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ST PAUL ELDER SERVICES INC
NPI 1053549980
Nursing Facility/Intermediate Care Facility in Kaukauna, WI

Active since June 30, 2009CLIA 52D0394453 · Waiver
316 E 14TH ST, KAUKAUNA, WI 54130(920) 766-6020 Get Directions Write a Review

NPPES record last updated: March 5, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About St Paul Elder Services Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST PAUL ELDER SERVICES INC (NPI 1053549980) is a healthcare organization registered as a nursing facility/intermediate care facility in Kaukauna, Wisconsin and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Mary Miller, Management, as its authorized official.

NPPES Registry Identity

NPI1053549980
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameST PAUL ELDER SERVICES INC
Location Address316 E 14TH STKaukauna, WI 54130-3304
Mailing Address316 E 14th StKaukauna, WI 54130-3304
Phone(920) 766-6020
Organization SubpartNo
Authorized OfficialMary MillerManagement · (920) 766-6020
Enumeration DateJune 30, 2009
Last NPPES UpdateMarch 5, 2010
✔ NPI 1053549980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
316 E 14TH ST, Kaukauna, WI 54130
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0394453

St Paul Elder Services Inc · Kaukauna, WI
Active · expires Aug 31, 2026
CLIA Number52D0394453
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMs. Lisa Sabin-Wilson
Laboratory Phone(920) 766-6020
Laboratory LocationSt Paul Elder Services Inc316 E 14th St, Kaukauna, WI 54130
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ST PAUL ELDER SERVICES, INC
Skilled Nursing Facility
316 E 14TH ST
KAUKAUNA, WI 54130
Outagamie County (920) 766-6020
LESLIE AARON MATZ COTA
Occupational Therapy Assistant
316 E 14TH ST
KAUKAUNA, WI 54130
Outagamie County (920) 766-6020
JENNIFER LYNN STELOW PTA
Physical Therapy Assistant
316 E 14TH ST
KAUKAUNA, WI 54130
Outagamie County (920) 766-6020
MRS. ALLISON MARIE MISCHLER PTA
Physical Therapy Assistant
316 E 14TH ST
KAUKAUNA, WI 54130
Outagamie County (920) 766-6020
LISA NEBEL DPT
Physical Therapist
316 E 14TH ST
KAUKAUNA, WI 54130
Outagamie County (920) 766-6020
MICHELE KNAPP-PINGEL PTA
Physical Therapy Assistant
316 E 14TH ST
KAUKAUNA, WI 54130
Outagamie County (920) 766-6202
BRIAN A MILLER COTA
Occupational Therapy Assistant
316 E 14TH ST
KAUKAUNA, WI 54130
Outagamie County (920) 766-6020
KATHLEEN S VAN ZEELAND MS,CCC-SLP
Speech-Language Pathologist
316 E 14TH ST
KAUKAUNA, WI 54130
Outagamie County (920) 766-6020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Paul Elder Services Inc's NPI number?

The NPI number for St Paul Elder Services Inc is 1053549980. It was assigned to this organization in the NPPES registry on June 30, 2009.

Where is St Paul Elder Services Inc located?

St Paul Elder Services Inc is located at 316 E 14th St, Kaukauna, WI 54130. The listed phone number is (920) 766-6020.

What is St Paul Elder Services Inc's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does St Paul Elder Services Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0394453) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St Paul Elder Services Inc was last updated on March 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.