Ccc of Pewaukee LLC is a Skilled Nursing Facility (organization) practicing in Waukesha, Wisconsin. The National Provider Identifier (NPI) is #1578049995, which was assigned on July 18, 2018, and the registration record was last updated on February 9, 2026. The practitioner's main practice location is at N26w23977 Watertown Rd, Waukesha, WI 53188-1006; the contact telephone number is 8479834860. The primary taxonomy of Ccc of Pewaukee LLC is Skilled Nursing Facility (314000000X). The authorized official for Ccc of Pewaukee LLC is David Merzel (Cfo).
(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.
| NPI | 1578049995 |
| Entity Type | Organization |
| Organization Name | CCC OF PEWAUKEE LLC |
| Provider Name | CCC OF PEWAUKEE LLC |
| Practice Address |
N26w23977 Watertown Rd Waukesha WI 53188-1006 |
| Practice Telephone | 8479834860 |
| Mailing Address |
5454 Fargo Ave Skokie IL 60077-3210 |
| Mailing Telephone | 8479834860 |
| Certification Date | 2026-02-09 |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2026-02-09 |
| Is Organization Subpart | N |
| Official Name | DAVID MERZEL |
| Official Title | CFO |
| Telephone | 8479834860 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility |
| Other Identifier | Issuing State | Issuer | Identifier Type |
|---|---|---|---|
| 000000000 | WI | MEDICAID | |
| 1578049995 | WI | MEDICAID |
| Other Organization Name | Type |
|---|---|
| Avina of Pewaukee | Doing Business As Name |
| Crossroads Care Center of Pewaukee | Doing Business As Name |
| Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| Classification | Skilled Nursing Facility |
| Grouping | Nursing & Custodial Care Facilities |
| 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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Bay Avenue Clhf, Inc. | 26197 Bay Ave, Moreno Valley, CA 92555-3850 | Skilled Nursing Facility | 2026-05-05 |
| Nh Rehabilitation Medicine PLLC | 442 Main St, Fremont, NH 03044-3434 | Skilled Nursing Facility | 2026-04-29 |
| Crossville Tn Opco LLC | 456 Wayne Ave, Crossville, TN 38555-4206 | Skilled Nursing Facility | 2026-05-07 |
| Southwestern Pa Opco LLC | 500 N Lewis Run Rd, Pittsburgh, PA 15122-3056 | Skilled Nursing Facility | 2026-04-28 |
| Oak Hills Management LLC | 617 S Air Depot Blvd, Midwest City, OK 73110-4426 | Skilled Nursing Facility | 2026-05-04 |
| Nhc Healthcare Lawrenceburg LLC | 374 Brink St, Lawrenceburg, TN 38464-3280 | Skilled Nursing Facility | 2026-04-30 |
| Marcela Congregate Living | 1969 N Lilac Avenue, Rialto, CA 92376 | Skilled Nursing Facility | 2026-04-30 |
| Martha Franks Senior Care LLC | 1 Martha Franks Dr, Laurens, SC 29360-1772 | Skilled Nursing Facility | 2026-05-01 |
| Harrogate Village Inc | 400 Locust St, Lakewood, NJ 08701-7408 | Skilled Nursing Facility | 2026-05-07 |
| Lincoln Healthcare Opco LLC | 5431 S 16th St, Lincoln, NE 68512-1206 | Skilled Nursing Facility | 2026-05-07 |
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| Street Address |
5454 FARGO AVE |
| City | SKOKIE |
| State | IL |
| Zip Code | 60077-3210 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Il Ltc Mht | 5454 Fargo Ave, Skokie, IL 60077-3210 | Clinical Social Worker | 2023-10-26 |
| Abigail Vanotterloo | 5454 Fargo Ave, Skokie, IL 60077-3210 | Speech-Language Pathologist | 2024-11-05 |
| Shefah Healthcare Sc | 5454 Fargo Ave Ste 107, Skokie, IL 60077-3210 | General Practice Physician | 2023-09-20 |
| Jennifer G Dzemske · Jennifer L Guenther | 5454 Fargo Ave, Skokie, IL 60077-3210 | Licensed Practical Nurse | 2012-07-19 |
| Glen Health & Home Management Inc | 5454 Fargo Ave, Skokie, IL 60077-3210 | Durable Medical Equipment & Medical Supplies | 2005-07-07 |
| Uziel Shefa Medical Sc | 5454 Fargo Ave Ste 107, Skokie, IL 60077-3210 | General Practice Physician | 2024-05-16 |
| Glen Saint Andrew Living Community, LLC | 5454 Fargo Ave, Skokie, IL 60077-3210 | Skilled Nursing Facility | 2014-12-22 |
| Allyson Baron · Allyson Fabry | 5454 Fargo Ave, Skokie, IL 60077-3210 | Physical Therapist | 2015-04-23 |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Rukhmini Pandit | 5252 Dempster St, Skokie, IL 60077 | Physical Therapist | 2017-02-20 |
| Marina Victoria Gruzmark · Marina Victoria Asipenka | 9655 Woods Dr., Unit 1811, Skokie, IL 60077 | Mental Health Counselor | 2016-01-05 |
| Joseph Rubin | 7929 Lincoln Ave Ste 202, Skokie, IL 60077 | Professional Counselor | 2018-06-20 |
| Carolyn Mary Jarozewski I | 5250 N.Old Orchard Road Suite 300, 5250 N.Old Orchard Road Suite 300, Skokie, IL 60077 | Registered Nurse | 2017-10-25 |
| Monica Brace | 5015 Estes, Skokie, IL 60077 | Physical Therapist | 2015-04-17 |
| My Dental Hub | 4905 Old Orchard Shopping Ctr Unit 221, Skokie, IL 60077 | Dental Clinic/Center | 2025-12-19 |
| Katie Kluga | 9977 Woods Drive Suite 300, Skokie, IL 60077 | Primary Care Nurse Practitioner | 2017-09-05 |
| Amy Wu Therapy, Ltd. | 5225 Old Orchard Rd., Suite 10, Skokie, IL 60077 | Community/Behavioral Health Agency | 2015-03-16 |
| Your Care Network, Inc. | 5250 Old Orchard Road, Suite 300, Skokie, IL 60077 | Homemaker | 2024-11-14 |
| Dominique Blue | 4957 Oakton Street, Pmb 112, Skokie, IL 60077 | Doula | 2026-01-06 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |