FREDERIC NURSING AND REHABILITATION COMMUNITY
NPI 1366440430
Skilled Nursing Facility in Frederic, WI

Active since July 12, 2005CLIA 52D0685199 · Waiver
205 UNITED WAY, FREDERIC, WI 54837(715) 327-4297(715) 327-4950 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Frederic Nursing And Rehabilitation Community NPPES

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

FREDERIC NURSING AND REHABILITATION COMMUNITY (NPI 1366440430) is a healthcare organization registered as a skilled nursing facility in Frederic, Wisconsin and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Keith Yoder, Cfo, as its authorized official.

NPPES Registry Identity

NPI1366440430
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCCG - FREDERIC
Location Address205 UNITED WAYFrederic, WI 54837-8938
Mailing Address5000 Hakes Dr, Suite 600Norton Shores, MI 49441-5574 · (231) 799-6870 · Fax (231) 799-0250
Fax(715) 327-4950
Organization SubpartNo
Authorized OfficialKeith YoderCfo · (614) 416-0600
Enumeration DateJuly 12, 2005
Last NPPES UpdateApril 20, 2008
NPI 1366440430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in WI · 3086
Definition
(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.
205 UNITED WAY, Frederic, WI 54837

Other Names 1

Doing Business AsFrederic Nursing And Rehabilitation Community

Other Identifiers 3

Other=========019WI · Bcbs Provider Code
Medicare OSCAR/certification525665WI
Medicaid20191100WI

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 52D0685199

Frederic Nursing & Rehabilitation Community · Frederic, WI
Active · expires Aug 31, 2026
CLIA Number52D0685199
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRuth Taylor
Laboratory Phone(715) 327-4297
Laboratory LocationFrederic Nursing & Rehabilitation Community205 United Way, Frederic, WI 54837
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

Physical Therapy Assistant
205 UNITED WAY
FREDERIC, WI 54837
Physical Therapy Assistant
205 UNITED WAY
FREDERIC, WI 54837
Physical Therapist
205 UNITED WAY
FREDERIC, WI 54837
Occupational Therapy Assistant
205 UNITED WAY
FREDERIC, WI 54837
Physical Therapy Assistant
205 UNITED WAY
FREDERIC, WI 54837
Skilled Nursing Facility
205 UNITED WAY
FREDERIC, WI 54837
Occupational Therapist
205 UNITED WAY
FREDERIC, WI 54837
Physical Therapy Assistant
205 UNITED WAY
FREDERIC, WI 54837

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 Ccg - Frederic's NPI number?

The NPI number for Ccg - Frederic is 1366440430. It was assigned to this organization in the NPPES registry on July 12, 2005. The provider is doing business as Frederic Nursing And Rehabilitation Community.

Where is Ccg - Frederic located?

Ccg - Frederic is located at 205 United Way, Frederic, WI 54837. The listed phone number is (715) 327-4297.

What is Ccg - Frederic's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Ccg - Frederic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0685199) 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 Ccg - Frederic was last updated on April 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.