INNOVATION ALLIANCE IPA LLC (NPI# 1831547397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831547397 |
| Entity Type | Organization |
| Organization Name | INNOVATION ALLIANCE IPA LLC |
| Practice Address |
2105 E Enterprise Ave Suite 101 Appleton WI 54913-7862 |
| Mailing Address |
2105 E Enterprise Ave Appleton WI 54913-7862 |
| Practice Telephone | 9205601100 |
| Practice Fax Number | 9205601112 |
| Mailing Telephone | 9205601100 |
| Mailing Fax Number | 9205601112 |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2019-05-22 |
| Authorized Official Name | MR. CURT KUBIAK (CEO) |
| Authorized Official Telephone | 9205601001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 305R00000X | Preferred Provider Organization | Managed Care Organizations | ||
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
2105 E ENTERPRISE AVE SUITE 101 |
| City | APPLETON |
| State | WI |
| Zip Code | 54913-7862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174504922 | Margaret Mary Hau | Occupational Therapist | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2005-11-09 |
| 1689024812 | Andrew Verhoeven | Physical Therapist | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2016-06-19 |
| 1679948566 | Padraic Obma, M.d., S.c. | Specialist | 2105 E Enterprise Ave, Suite 112, Appleton, WI 54913-7862 | 2015-12-03 |
| 1639550569 | Theodore Donald Kurlinkus | Physical Therapist | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2015-06-16 |
| 1285012872 | Fox Valley Transitional Care LLC | Skilled Nursing Facility | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2015-05-14 |
| 1801287305 | Megan Lee | Specialist/Technologist | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2015-02-05 |
| 1295132496 | Fox Valley Orthopaedic Surgeon's Association, Inc | Orthopaedic Surgery | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2014-12-03 |
| 1912344417 | William Harold Hartmann | Physical Therapist | 2105 E Enterprise Ave, Suite 113, Appleton, WI 54913 | 2013-05-24 |
| 1992049175 | Tyler L Vanderzanden | Physical Therapist | 2105 E Enterprise Ave, Suite 113, Appleton, WI 54913-7862 | 2012-11-12 |
| 1144570870 | Kenneth L. Schaufelberger, M.d., S.c. | Specialist | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2012-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
| 1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
| 1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
| 1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
| 1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
| 1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
| 1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
| 1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
| 1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
| 1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
| Find all providers in zip 54913 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316068091 | Cathy M Olson | Specialist | 3305c North Ballard Rd., Appleton, WI 54911-9001 | 2007-04-02 |
| 1265490437 | Timothy Ivan Zuck | Specialist | 5395 Michaels Dr, Appleton, WI 54913-8447 | 2006-05-03 |
| 1699777144 | Mark John Scherer | Specialist | 610 E Longview Dr, Appleton, WI 54911-2149 | 2005-08-15 |
| 1679948566 | Padraic Obma, M.d., S.c. | Specialist | 2105 E Enterprise Ave, Suite 112, Appleton, WI 54913-7862 | 2015-12-03 |
| 1881077295 | Kayla B Schneider | Specialist | 2105 E Enterprise Ave Ste 113, Appleton, WI 54913-7862 | 2015-07-02 |
| 1144570870 | Kenneth L. Schaufelberger, M.d., S.c. | Specialist | 2105 E Enterprise Ave, Appleton, WI 54913-7862 | 2012-09-10 |
| 1366745804 | Kristin Nicole Wallace | Specialist | 1506 S Oneida St, Appleton, WI 54915-1305 | 2010-12-06 |
| 1043461460 | Fox Valley Gastroenterology, S.c. | Specialist | 900 E Grant St, Appleton, WI 54911-3487 | 2008-10-03 |
| 1730238890 | Kagen Dermatology Clinic Sc | Specialist | 100 W Lawrence St, Suite 409, Appleton, WI 54911-5773 | 2007-01-09 |
| 1265590848 | Fox Valley Pulmonary Medicine, LLC | Specialist | 820 E Grant St, Suite S 250, Appleton, WI 54911-3483 | 2006-12-05 |
| Find all providers in APPLETON | ||||
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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.