Cross-source identifiers
Every current identifier attachment, with the link method and confidence carried verbatim — deterministic links are 1.000; probabilistic links surface their real matcher confidence, never rounded up.
| Scheme | Value | Source table | Link method | Confidence | Since | Provenance |
|---|---|---|---|---|---|---|
| npi | 1558615815 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1558615815","entity_type_code":"2"} |
| pecos_enrlmt_id | O20121213000262 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1558615815","rule":"D-PECOS","enrlmt_id":"O20121213000262"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← owns | SERGEI NICHOLAS SHVETZOFF | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"12/01/2012","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0446248579","source_pk":125574,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | OWNER PAC 0648760116 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"10/01/2012","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0648760116","source_pk":125575,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | STATE OF WISCONSIN (WI) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"10/01/2012","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"1456369826","source_pk":125576,"type_owner":"O","enrollment_id":"O20121213000262","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | HEALTH DIMENSIONS CONSULTING INC (MN) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"12/01/2012","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1759379878","source_pk":125579,"type_owner":"O","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | KATIE MARIE PLENDL | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"06/23/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1759754906","source_pk":125581,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | PATRICIA LYNN BRISCOE | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"12/01/2012","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2264956531","source_pk":125583,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | LAUREN SAUTER (WI) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"06/13/2018","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2769799642","source_pk":125584,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | ERIN LEIGH SHVETZOFF HENNESSEY | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2020","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3971744335","source_pk":125586,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | DAVID LINDSAY BRISCOE | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"12/01/2012","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4284622317","source_pk":125587,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | JAMES PARKER | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"04/22/2012","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4880026608","source_pk":125588,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | OWNER PAC 5294225769 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/16/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5294225769","source_pk":125591,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | OWNER PAC 6103316674 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/29/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6103316674","source_pk":125592,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | OWNER PAC 7113417684 (WI) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/21/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7113417684","source_pk":125593,"type_owner":"O","enrollment_id":"O20121213000262","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | OWNER PAC 7911497482 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"02/18/2013","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7911497482","source_pk":125594,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | OWNER PAC 8022508597 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/09/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8022508597","source_pk":125595,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | OWNER PAC 8820588395 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"05/08/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8820588395","source_pk":125596,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | AMBER ROGOTZKE | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2020","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9133557630","source_pk":125597,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | TAMMY L SERVATIUS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/14/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9234561051","source_pk":125598,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | TAMI LYN SHVETZOFF | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"12/01/2012","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9537683800","source_pk":125601,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
| ← owns | OWNER PAC 9739679200 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"02/11/2013","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9739679200","source_pk":125602,"type_owner":"I","enrollment_id":"O20121213000262","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"STATE OF WISCONSIN"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1558615815 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| dba_name | <UNAVAIL> | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| enumeration_date | 2012-11-07 | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| legal_business_name | STATE OF WISCONSIN | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| practice_state | WI | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| primary_taxonomy | 314000000X | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
Provider screening signals
NPI-keyed source families read directly for 1558615815: federal and state integrity lists, CMS Open Payments, Order and Referring eligibility, Medicare opt-out, and enrollment revalidation. Cells expose the source and provenance fields supplied by the selected record. A screening aid — re-confirm any match against the primary source before acting; absence means nothing on file in the data Fonteum currently holds, never a guarantee none exists.
Sanctions & integrity
Coverage staleExclusion coverage is stale or cannot be reconciled to an attested source artifact. This result is indeterminate and must not be treated as a clearance; check the current issuing-agency lists.
- Coverage status: indeterminate
- Screened 26 integrity lists; no negative determination was made.
14-tuple provenance (26)
Industry payments
None on file0 CMS Open Payments records on file for this NPI.
14-tuple provenance (1)
Order & referring eligibility
None on fileNo CMS Order and Referring record on file for this NPI.
14-tuple provenance (1)
Medicare opt-out
None on fileNo CMS Medicare opt-out affidavit on file for this NPI.
14-tuple provenance (1)
Revalidation
On file1 Medicare enrollment record on file.
- Due date: TBD upstream — not due within the ensuing six months.
14-tuple provenance (1)
Point-in-time
Query retained claim coordinates under bitemporal-read/v1. Most facts have no superseded row; dates outside retained coverage may return no prior version, and diffs require both coordinates.
Pick a date to reconstruct, or two dates to diff. Equivalent JSON: /api/v1/history/{subject_type}/{subject_id}?at=… and …/diff?from=…&to=…