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FORT HEALTHCARE HOME HEALTH
NPI 1063566966
Home Health in Fort Atkinson, WI

Active since January 22, 2007CLIA Certified · 3 labs
611 SHERMAN AVE E, FORT ATKINSON, WI 53538(920) 568-5000 Get Directions Write a Review

NPPES record last updated: October 7, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fort Healthcare Home Health NPPES

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

FORT HEALTHCARE HOME HEALTH (NPI 1063566966) is a healthcare organization registered as a home health in Fort Atkinson, Wisconsin and active in the NPI registry since January 2007. The organization holds 3 active CLIA laboratory certificates and lists James J. Nelson, Senior Vice President, Finance, as its authorized official.

NPPES Registry Identity

NPI1063566966
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameFORT HEALTHCARE, INC
Location Address611 SHERMAN AVE EFort Atkinson, WI 53538-1960
Mailing Address611 Sherman Ave EFort Atkinson, WI 53538-1960 · (920) 568-5000
Phone(920) 568-5000
Organization SubpartNo
Authorized OfficialJames J. NelsonSenior Vice President, Finance · (920) 568-5000
Enumeration DateJanuary 22, 2007
Last NPPES UpdateOctober 7, 2022
NPPES CertifiedOctober 7, 2022
✔ NPI 1063566966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License✔ Licensed in WI · 137
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
611 SHERMAN AVE E, Fort Atkinson, WI 53538
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Other Names 1

Doing Business AsFort Healthcare Home Health

CLIA Laboratory Certificates CMS CLIA 3

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 52D2261039

Fort Healthcare · Fort Atkinson, WI
Active · expires May 24, 2028
CLIA Number52D2261039
Laboratory TypeComm Health School Nurse
Certificate Effective DateMay 25, 2026
Certificate Expiration DateMay 24, 2028
Laboratory DirectorDr. James P. Martin
Laboratory Phone(920) 568-6080
Laboratory LocationFort Healthcare611 Sherman Ave E, Fort Atkinson, WI 53538
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 52D2037670

Fort Healthcare · Fort Atkinson, WI
Active · expires Mar 4, 2028
CLIA Number52D2037670
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateMarch 5, 2026
Certificate Expiration DateMarch 4, 2028
Laboratory DirectorDr. Douglas S. Keehn
Laboratory Phone(920) 568-5263
Laboratory LocationFort Healthcare1604 Madison Ave, Fort Atkinson, WI 53538
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 52D0392761

Fort Healthcare Laboratory · Fort Atkinson, WI
Active · expires Feb 8, 2027
CLIA Number52D0392761
Laboratory TypeHospital
Certificate Effective DateFebruary 9, 2025
Certificate Expiration DateFebruary 8, 2027
Laboratory DirectorDr. Kabeer Shah
Laboratory Phone(920) 568-5259
Laboratory LocationFort Healthcare Laboratory611 E Sherman Ave, Fort Atkinson, WI 53538
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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.

BONNIE L POPPY APNP
Nurse Practitioner
611 SHERMAN AVE E
FORT ATKINSON, WI 53538
Jefferson County (920) 563-5571
PATRICIA A STECKELMANN P.A.
Physician Assistant
611 SHERMAN AVE E
FORT ATKINSON, WI 53538
Jefferson County (920) 568-5330
DR. ROBERT P SIEVERT D.O.
Emergency Medicine
611 SHERMAN AVE E
FORT ATKINSON, WI 53538
Jefferson County (920) 568-5330
THOMAS R. PERRY, M.D.,S.C.
Psychiatry & Neurology (Neurology)
611 SHERMAN AVE E
FORT ATKINSON, WI 53538
Jefferson County (920) 568-5334
ELIZABETH J HANS
Social Worker
611 SHERMAN AVE E
FORT ATKINSON, WI 53538
Jefferson County (608) 647-4705
DAWN ELIZABETH KUBLY PT
Physical Therapist
611 SHERMAN AVE E
FORT ATKINSON, WI 53538
Jefferson County (920) 568-5299
BRADLEY THOMAS WAGNER CRNA
Nurse Anesthetist, Certified Registered
611 SHERMAN AVE E
FORT ATKINSON, WI 53538
Jefferson County (920) 568-5000
DEBORAH L ROE APNP
Nurse Practitioner (Adult Health)
611 SHERMAN AVE E
FORT ATKINSON, WI 53538
Jefferson County (920) 568-6090

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 Fort Healthcare, Inc's NPI number?

The NPI number for Fort Healthcare, Inc is 1063566966. It was assigned to this organization in the NPPES registry on January 22, 2007. The provider is doing business as Fort Healthcare Home Health.

Where is Fort Healthcare, Inc located?

Fort Healthcare, Inc is located at 611 Sherman Ave E, Fort Atkinson, WI 53538. The listed phone number is (920) 568-5000.

What is Fort Healthcare, Inc's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Fort Healthcare, Inc hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Fort Healthcare, Inc was last updated on October 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.