JUSTIN C BRONDSTAD AT YOUR SERVICE LLC


Address: 1215 W Cramer St, Fort Atkinson, WI 53538-1001
Phone: 6084511708

JUSTIN C BRONDSTAD AT YOUR SERVICE LLC (NPI# 1174178040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174178040
Entity Type Organization
Organization Name JUSTIN C BRONDSTAD AT YOUR SERVICE LLC
Practice Address 1215 W Cramer St
Fort Atkinson
WI 53538-1001
Practice Telephone 6084511708
Mailing Telephone 6084511708
Enumeration Date 2019-08-07
Last Update Date 2019-08-07
Authorized Official Name JUSTIN C BRONDSTAD (OWNER/OPERATOR)
Authorized Official Telephone 6084511708
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 305S00000X Point of Service Managed Care Organizations

Office Location

Street Address 1215 W CRAMER ST
City FORT ATKINSON
State WI
Zip Code 53538-1001

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1306383468 Chelsey Turk Specialist/Technologist 1231 Orchard Lane, Fort Atkinson, WI 53538 2017-01-27
1639625452 Insight Counseling Services Community/Behavioral Health 615 Frederick Ave., Fort Atkinson, WI 53538 2016-08-31
1912355314 Melissa Anne Gleason Trimbell Dentist 520 Handeyside Ln Ste 4, Fort Atkinson, WI 53538 2016-05-26
1295141943 Brittany K Romans Registered Nurse 1230 Commonwealth Dr, 1, Fort Atkinson, WI 53538 2014-07-02
1023367117 June Ann Sullivan Occupational Therapy Assistant 815 West Cramer Street, Fort Atkinson, WI 53538 2012-09-05
1306080551 Mary Kathleen Bornick Licensed Practical Nurse W. 6143 N. Thornapple Court, Fort Atkinson, WI 53538 2009-04-30
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Taxonomy Information

Taxonomy Code 305S00000X
Grouping Managed Care Organizations
Classification Point of Service

Taxonomy Definition

This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
Notes: Source: "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. 62

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1194269407 Checkpoint Industries Point of Service 8330 N Teutonia Ave, 103, Brown Deer, WI 53209-1550 2016-12-06
1649726837 Alahnui Health Services LLC Point of Service 9000 W Kaul Ave, Milwaukee, WI 53225-2018 2016-08-29
1437524485 Christopher Gunderson Point of Service 911 Jackson St # 213, Wausau, WI 54403-5696 2015-12-02
1235502493 The Smith LLC Point of Service 9545 S 20th St Ste 2, Oak Creek, WI 53154-4929 2015-11-09
1992185631 Care for All Ages Point of Service 1308 S Norwood Ave, Green Bay, WI 54304-1001 2015-06-08
1467847509 Health Grades Point of Service 2927 Coho St, Madison, WI 53713-3069 2015-04-06
1326449604 Soul To Soul Massage LLC Point of Service 604 E 3rd St, Marshfield, WI 54449-4511 2014-09-05
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Competitor

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City FORT ATKINSON
Zip Code 53538

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Dataset Information

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.

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