INTERRA HEALTH INC. (NPI# 1700335288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700335288 |
| Entity Type | Organization |
| Organization Name | INTERRA HEALTH INC. |
| Other Organization Name | THREE WAVES INHEALTH CLINIC AND WELLNESS CENTER |
| Practice Address |
1675 N Barker Rd Suite 200 Brookfield WI 53045-5200 |
| Mailing Address |
292 Ohio St Oshkosh WI 54902-5825 |
| Practice Telephone | 4147554898 |
| Mailing Telephone | 9202675332 |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |
| Authorized Official Name | DR. KYLE HANSEN (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 4147554898 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
43771-20 | WI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Three Waves InHealth Clinic and Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043703838 | Interra Health Inc. | Clinic/Center | 5 Innovation Ct Ste B, Appleton, WI 54914-1739 | 2018-06-07 |
| 1407307374 | Interra Health Inc. | Clinic/Center | 120 Brost Dr, Morrison, TN 37357-1500 | 2016-10-17 |
| 1083163968 | Interra Health Inc. | Clinic/Center | 600 N Virginia Ave, Winter Park, FL 32789 | 2016-10-03 |
| 1073067013 | Interra Health Inc. | Clinic/Center | N4993 6th Dr, Westfield, WI 53964-8200 | 2016-08-08 |
| 1760035513 | Interra Health Inc. | Clinic/Center | 831 Simpson Rd, Kissimmee, FL 34744-5328 | 2019-07-22 |
| 1952896409 | Interra Health Inc. | Clinic/Center | 292 Ohio St, Oshkosh, WI 54902-5825 | 2018-06-27 |
| 1538652144 | Interra Health Inc. | Clinic/Center | 3003 Breezewood Ln, Neenah, WI 54956-9611 | 2018-06-08 |
| Street Address |
1675 N BARKER RD SUITE 200 |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53045-5200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801436159 | Jeannie Spoon | Behavioral Analyst | 200 N. Patrick Blvd. Ste 250, Brookfield, WI 53045 | 2020-01-14 |
| 1629635313 | Hallie Mackenzie Ritchay | Speech-Language Pathologist | Greenfield Rehabilitation Agency 19395 W Capitol Dr, Ste 200, Brookfield, WI 53045 | 2019-05-29 |
| 1427535038 | Kimberly Ann Beres | Registered Nurse | 2253 Norhardt Dr, Brookfield, WI 53045 | 2018-07-26 |
| 1265927768 | Brady Frederick Bachmann | Physical Therapist | 275 Regency Ct., Suite 200, Brookfield, WI 53045 | 2018-06-27 |
| 1841792603 | Wisconsin Renal Care Group, L.L.C. | Clinic/Center | 17500 W Capitol Drive, Brookfield, WI 53045 | 2018-03-07 |
| 1750828299 | Nanette Marie Kloth | Nurse Practitioner | 18110 W Bluemond Rd, Brookfield, WI 53045 | 2017-01-23 |
| 1144772013 | Saida Reifenrath | Acupuncturist | 240 Regency Court, Suite 102, Brookfield, WI 53045 | 2016-10-26 |
| 1437545951 | Kylee Stevenson | Chiropractor | 19555 W Bluemound Rd Ste 6, Brookfield, WI 53045 | 2015-04-10 |
| 1548659725 | Patricia Ann Kender | Nurse Practitioner | 17495 W. Capitol Dr., Brookfield, WI 53045 | 2015-01-12 |
| 1568882793 | Kassandra E Holzem | Dermatology | 195 Discovery Dr, Brookfield, WI 53045 | 2014-04-28 |
| Find all providers in zip 53045 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083088058 | Advanced Medical House Call and Telemedicine, L.L.C. | Clinic/Center | 624 W Lockling St, Brookfield, MO 64628-2003 | 2015-11-13 |
| 1295110823 | Quad Med LLC | Clinic/Center | 17000 W North Ave, Brookfield, WI 53005 | 2015-07-24 |
| 1598086928 | Healing Corner, LLC | Clinic/Center | 19115 W Capitol Dr, 117, Brookfield, WI 53045-2754 | 2010-06-21 |
| 1134378789 | Family Doctors of Brookfield Sc | Clinic/Center | 8905 Burlington Ave, Brookfield, IL 60513-2034 | 2008-09-18 |
| 1023225042 | Lorelle M Manion, Md, Sc | Clinic/Center | 1305 N Barker Rd, Suite 1, Brookfield, WI 53045-5230 | 2007-05-17 |
| 1336356336 | Lorelle Michelle Manion | Clinic/Center | 1305 N Barker Rd, Brookfield, WI 53045-5230 | 2007-05-17 |
| 1205928553 | Elmbrook Internal Medicine Associates S.c. | Clinic/Center | 17000 W North Ave, Suite 200e, Brookfield, WI 53005-4423 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122097 | Whole You Acupuncture and Health Consulting LLC | Clinic/Center | 3330 University Ave Ste 205, Madison, WI 53705-2167 | 2020-10-21 |
| 1588275036 | Abifka Healthcare Inc. | Clinic/Center | 8725 S Wood Creek Dr, Oak Creek, WI 53154-7502 | 2020-08-10 |
| 1306483508 | Achieve Wellness Clinic | Clinic/Center | 1417 Winchester Way, Suite 6, Altoona, WI 54720-5472 | 2019-12-06 |
| 1386295061 | Careatc | Clinic/Center | 1400 E Wisconsin St, Delavan, WI 53115-1470 | 2019-09-24 |
| 1295386977 | Careatc | Clinic/Center | 4600 W Loomis Rd Ste 200, Greenfield, WI 53220-4858 | 2019-09-24 |
| 1639728496 | Quad/med, LLC | Clinic/Center | 725 South Street, Mayville, WI 53050 | 2019-09-05 |
| 1316505464 | New Richmond Family Care, LLC | Clinic/Center | 1500 Madison Ave # 5c, New Richmond, WI 54017-6693 | 2019-06-04 |
| 1609433705 | Activate Healthcare | Clinic/Center | 660 Vandeberg St, Baldwin, WI 54002-3251 | 2019-05-23 |
| 1043703838 | Interra Health Inc. | Clinic/Center | 5 Innovation Ct Ste B, Appleton, WI 54914-1739 | 2018-06-07 |
| 1942792254 | Quad/med, LLC | Clinic/Center | 1900 W. Sumner Street, Hartford, WI 53027 | 2018-06-01 |
| Find all providers with the same taxonomy | ||||
| City | BROOKFIELD |
| Zip Code | 53045 |
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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.