OrganizationActive
Ccg - Frederic
NPI 1366440430 · Skilled Nursing Facility · Frederic, WI
Provider details
- NPI number
- 1366440430
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Keith Yoder, Cfo(614) 416-0600
- License
- 3086 (WI)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
205 United Way
Frederic, WI 54837-8938
Phone: (715) 327-4297
Fax: (715) 327-4950
Street-level locationGet directions
Mailing address
5000 Hakes Dr
Norton Shores, MI 49441-5574
Other names (DBA / former)
- Doing business as
- Frederic Nursing and Rehabilitation Community
Registry dates
- Enumerated
- 2005-07-12
- Last updated
- 2008-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.