{
"Npi": {
"NPI": "1326139049",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "MARSHFIELD CLINIC HEALTH SYSTEM INC",
"ParentOrgTIN": null,
"OrgName": "LAKEVIEW MEDICAL CENTER INC OF RICE LAKE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1000 N OAK AVE",
"SecondLineMailingAddress": "PROVIDER ENROLLMENT SVCS - SHP FL2",
"MailingAddressCityName": "MARSHFIELD",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "54449-5703",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "715-387-5511",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1215 W KNAPP ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICE LAKE",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "54868-1307",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "715-236-6256",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/27/2006",
"LastUpdateDate": "03/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRESSLER",
"AuthorizedOfficialFirstName": "KATHLEEN",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "COO, AO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "715-975-6018",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "151",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}