PAIN CENTERS OF WISCONSIN - BEAVER DAM, LLC (NPI# 1437419561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437419561 |
| Entity Type | Organization |
| Organization Name | PAIN CENTERS OF WISCONSIN - BEAVER DAM, LLC |
| Practice Address |
1701 N Spring St Beaver Dam WI 53916-1178 |
| Mailing Address |
4131 W Loomis Rd Ste 300 Greenfield WI 53221-2057 |
| Practice Telephone | 4143257246 |
| Practice Fax Number | 4143253770 |
| Mailing Telephone | 4143257246 |
| Mailing Fax Number | 4143253770 |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2016-10-24 |
| Authorized Official Name | VISHAL LAL (CEO) |
| Authorized Official Telephone | 4143257246 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356904254 | Pain Centers of Wisconsin - Beaver Dam, LLC | Durable Medical Equipment & Medical Supplies | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2019-04-16 |
| Street Address |
1701 N SPRING ST |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-1178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356904254 | Pain Centers of Wisconsin - Beaver Dam, LLC | Durable Medical Equipment & Medical Supplies | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2019-04-16 |
| 1871067553 | Chris Alan Thomas II | Nurse Practitioner | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2019-01-16 |
| 1619360179 | Advanced Pain Management Sc | Durable Medical Equipment & Medical Supplies | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2015-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718283 | Paulette Neibauer | Technician | N7262 Farwell Rd., Beaver Dam, WI 53916 | 2019-09-05 |
| 1902336597 | Tricounty Homecare Inc | In Home Supportive Care | 140 Corporate Dr Ste 2, Beaver Dam, WI 53916 | 2017-06-15 |
| 1528502754 | Jessica Marie Blatz | Counselor | 809 Park Aveune, Beaver Dam, WI 53916 | 2016-12-07 |
| 1376090886 | Beaver Dam Hearing Care, LLC | Hearing Aid Equipment | 705 University Ave, Suite 170, Beaver Dam, WI 53916 | 2016-09-01 |
| 1275902546 | Beaver Dam Community Hospitals Inc | Pharmacy | 705 S University Ave Ste 180, Beaver Dam, WI 53916 | 2015-09-17 |
| 1609242825 | Tami Joe Delisle | Counselor | 207 North Spring Street, Beaver Dam, WI 53916 | 2015-08-12 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1326471608 | Raquel Rodriguez-guzman | Pharmacist | 205 La Crosse Street, Beaver Dam, WI 53916 | 2013-08-09 |
| 1558608828 | Mary Y Kunz | Licensed Practical Nurse | 6550 N Highway 151 Lot 63, Beaverdam, WI 53916 | 2013-01-07 |
| 1881938454 | Brock Holden Slinger | Physical Therapist | 205 Monroe St. #13, Beaver Dam, WI 53916 | 2012-11-20 |
| Find all providers in zip 53916 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113841 | Spine Solutions of West Bend LLC | Clinic/Center | 1000 Gateway Ct Ste 200, West Bend, WI 53095-8541 | 2020-10-29 |
| 1205454626 | Eye Surgery Center of Wisconsin, LLC | Clinic/Center | 10148 S 27th St, Oak Creek, WI 51354 | 2020-07-13 |
| 1083242325 | Appleton Surgical Center LLC | Clinic/Center | 1616 N Casaloma Dr # 200, Appleton, WI 54913-8245 | 2020-03-31 |
| 1164056974 | Orthopedic Surgery Center of The Fox Valley LLC | Clinic/Center | 1205 W. American Drive, Neenah, WI 54596-5459 | 2020-03-02 |
| 1013548833 | Ascension Wisconsin Surgery Center-mount Pleasant LLC | Clinic/Center | 10180 Washington Ave Ste 200, Mount Pleasant, WI 53177-1604 | 2020-01-30 |
| 1497393516 | Aurora Surgery Centers, LLC | Clinic/Center | 12500 Aurora Drive, Pleasant Prairie, WI 53158 | 2019-12-19 |
| 1275178444 | Kenosha Digestive Health Center LLC | Clinic/Center | 8220 75th St, Kenosha, WI 53142-7637 | 2019-11-12 |
| 1851887715 | Southern Lakes Endoscopy LLC | Clinic/Center | 240 Maple Ave Ste 2220, Mukwonago, WI 53149-8475 | 2018-07-03 |
| 1447768411 | Wisconsin Institute of Surgical Excellence LLC | Clinic/Center | 1265 W American Dr Ste 200, Neenah, WI 54956 | 2018-01-12 |
| 1629518006 | Great Lakes Surgery LLC | Clinic/Center | 6123 Green Bay Rd Ste 101, Kenosha, WI 53142-2927 | 2017-03-03 |
| Find all providers with the same taxonomy | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
Please comment or provide details below to improve the information on PAIN CENTERS OF WISCONSIN - BEAVER DAM, LLC.
| 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.