AMS OF WISCONSIN, LLC (NPI# 1003150004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003150004 |
Entity Type | Organization |
Organization Name | AMS OF WISCONSIN, LLC |
Practice Address |
9532 E 16 Frontage Rd Suite 100 Onalaska WI 54650-6739 |
Practice Telephone | 6087830506 |
Practice Fax Number | 6087830242 |
Mailing Telephone | 6087830506 |
Mailing Fax Number | 6087830242 |
Enumeration Date | 2012-11-15 |
Last Update Date | 2012-11-15 |
Authorized Official Name | MR. MICHAEL ERRICO (PRESIDENT) |
Authorized Official Telephone | 6087830506 |
Authorized Official Credential | MS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
2971 | WI | Ambulatory Health Care Facilities |
Street Address |
9532 E 16 FRONTAGE RD SUITE 100 |
City | ONALASKA |
State | WI |
Zip Code | 54650-6739 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316545452 | Kayla Fausti | Counselor | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2020-10-12 |
1043843048 | Katlyn Becker | Counselor | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2020-02-18 |
1093347650 | Aubryana Sullivan | Counselor | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2020-02-11 |
1861032435 | Jay Zabel | Registered Nurse | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2020-01-13 |
1922643881 | Susan Doehlert | Registered Nurse | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2019-11-14 |
1831730753 | William Boisvert | Registered Nurse | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2019-10-02 |
1538725932 | Jennie Simms | Registered Nurse | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2019-05-13 |
1063987576 | Beth Clements | Registered Nurse | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2018-10-11 |
1710452420 | Matthew Kinserdahl | Registered Nurse | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2018-10-09 |
1396228987 | Elaine Stika | Registered Nurse | 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | 2018-09-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568824027 | Kyle Quillin | Student in an Organized Health Care Education/Training Program | 236 Kevin Ct, Onalaska, WI 54650 | 2016-03-24 |
1831577881 | Katelyn Nicole Patten | Counselor | 575 Lester Ave, Onalaska, WI 54650 | 2015-05-11 |
1619369758 | Amelia Vruble | Registered Nurse | 1047 Terrace Drive, Onalaska, WI 54650 | 2015-02-26 |
1699186528 | C. Nathan Vannatta | Physical Therapist | 3111 Gunersen Dr, Onalaska, WI 54650 | 2014-05-13 |
1770867640 | Claire Sweet | Pharmacist | 9400 Hwy 16, Target T-0620, Onalaska, WI 54650 | 2011-10-10 |
1306140439 | Jared I Darveaux | Internal Medicine | 311 Gundersen Dr, Onalaska, WI 54650 | 2011-01-04 |
1326299488 | Demetrios Spyridon Theodoropoulos | Allergy & Immunology | 2727 Midwest Drive, Onalaska, WI 54650 | 2008-10-08 |
1114190618 | Nancy Ellen Reithel | Physical Therapist | 610 Westwood Drive, Onalaska, WI 54650 | 2008-04-07 |
1902972896 | Maplewood Dental | Dentist | 1202 County Trunk Ph, Suite 300, Onalaska, WI 54650 | 2006-11-24 |
1245309327 | Benjamin John Breidenbach | Chiropractor | 1640 George St, Lacrosse, WI 54650 | 2006-11-06 |
Find all providers in zip 54650 |
Taxonomy Code | 261QM2800X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Methadone Clinic |
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356951321 | Premier Care of Wisconsin, LLC. | Clinic/Center | 1333 College Ave Ste M1, South Milwaukee, WI 53172-1150 | 2020-08-05 |
1013572353 | Addiction Services and Pharmacotherapy, Sc | Clinic/Center | 11390 W Theo Trekr Way, West Allis, WI 53214-1135 | 2019-05-02 |
1740767292 | Ansa Treatment Center Inc | Clinic/Center | 4111 N Port Washington Rd Ste 101a, Milwaukee, WI 53212-1029 | 2018-07-26 |
1265922660 | Addiction Services and Pharmacotherapy, Sc | Clinic/Center | 210 E Olin Ave, Madison, WI 53713-1434 | 2018-05-11 |
1194992404 | Milwaukee Health Services System, LLC | Clinic/Center | 5109 World Dairy Dr, Madison, WI 53718-3807 | 2008-05-15 |
1780850594 | Milwaukee Health Services System, LLC | Clinic/Center | 3707 N Richards St, Milwaukee, WI 53212-1673 | 2008-05-01 |
1174798524 | Milwaukee Health Services System, LLC | Clinic/Center | 4800 S 10th St Unit 1, Milwaukee, WI 53221-2412 | 2008-04-28 |
1093912768 | C.o.r.e.,llc | Clinic/Center | 4555 W Schroeder Dr Ste 185, Brown Deer, WI 53223-1494 | 2007-06-27 |
1336247139 | Milwaukee Health Services System, LLC | Clinic/Center | 210 Washington St., Wausau, WI 54403-5475 | 2006-09-20 |
1881131761 | Psychological Addiction Services LLC | Clinic/Center | 3113 E Washington Ave, Madison, WI 53704-4330 | 2017-01-30 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.