Ccg - Frederic
Ccg - Frederic is a healthcare organization registered as Skilled Nursing Facility in Frederic, WI, holding Type 2 (organization) NPI 1366440430 since 2005. The authorized official on file is Keith Yoder, Cfo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1366440430 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Ccg - Frederic |
| Other name | <Unavail> |
| Practice address | 205 UNITED WAY, Frederic, WI, 54837 |
| Phone | 7153274297 |
| Fax | 7153274950 |
| Enumeration date | 2005-07-12 |
| Last updated in NPPES | 2008-04-20 |
Authorized official
| Name | Keith Yoder |
|---|---|
| Title | Cfo |
| Phone | 6144160600 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | Primary | 3086 | WI |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20191100 | Medicaid | WI | — |
Copy-ready billing details
Provider: Ccg - Frederic NPI: 1366440430 Taxonomy: 314000000X (Skilled Nursing Facility) Address: 205 UNITED WAY, Frederic, WI, 54837
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1528246626 | Orion Frederic LLC | Organization | Skilled Nursing Facility | Frederic, WI |
| 1255636890 | Laurie Breeden | Individual | Physical Therapy Assistant | Frederic, WI |
| 1477858017 | Debra Erwin | Individual | Occupational Therapy Assistant | Frederic, WI |
| 1700155090 | Kandis Olson | Individual | Occupational Therapist | Frederic, WI |
| 1487122040 | David Foss | Individual | Physical Therapy Assistant | Frederic, WI |
| 1245880533 | Kyle Steffen | Individual | Physical Therapy Assistant | Frederic, WI |
| 1316608425 | Caitlin Nimm | Individual | Physical Therapist | Frederic, WI |
| 1578208302 | Jillian Williamson | Individual | Occupational Therapist | Frederic, WI |
Verify this record
Cross-check NPI 1366440430 against the authoritative CMS record: view Ccg - Frederic on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Ccg - Frederic?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-04-20.