STATE MEDICAID (NPI# 1891898219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891898219 |
| Entity Type | Organization |
| Organization Name | STATE MEDICAID |
| Practice Address |
824 Lothe St Sun Prairie WI 53590-2710 |
| Practice Telephone | 6083340900 |
| Mailing Telephone | 6083340900 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MISS JANICE REMUS (CASE MANAGER) |
| Authorized Official Telephone | 6088487745 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | WI | Managed Care Organizations |
| Street Address |
824 LOTHE ST |
| City | SUN PRAIRIE |
| State | WI |
| Zip Code | 53590-2710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194280529 | Kasi Lucas Schroeder | Chiropractor | 110 N Grand Ave, Suite 4, Sun Prairie, WI 53590 | 2019-02-11 |
| 1770053712 | Jamie Engstrom | Psychologist | 3061 Pleasant St, 216, Sun Prairie, WI 53590 | 2018-12-03 |
| 1154837433 | Wisconsin Dental Health, LLC | Dentist | 390 S. Grand Ave, Suite#110, Sun Prairie, WI 53590 | 2017-12-21 |
| 1669981676 | Elizabeth M Gregg | Counselor | 1170 N Bird St, Sun Prairie, WI 53590 | 2017-09-21 |
| 1609298595 | Prairie Lakes Dental | Dentist | 2804 Prairie Lakes Drive, Sun Prairie, WI 53590 | 2014-01-10 |
| 1407297559 | Quality Medical Rides LLC | Non-emergency Medical Transport (VAN) | 2907 Vang Rd, Sun Prairie, WI 53590 | 2013-07-17 |
| 1376892851 | Costco Wholesale Corporation | Pharmacy | 2850 Hoepker Rd, Sun Prairie, WI 53590 | 2012-08-30 |
| 1043454234 | Dean Lewis Drake | Registered Nurse | 7281 County Rd V. V., Sun Prairie, WI 53590 | 2009-05-01 |
| 1679728992 | Dianne Mary Mayr | Registered Nurse | 3181 Nature Dr, Conservancy States Ln, Sun Prairie, WI 53590 | 2008-12-01 |
| 1043462021 | Crown Point Village, LLC | Assisted Living Facility | 881 Liberty Boulevard, Sun Prairie, WI 53590 | 2008-10-21 |
| Find all providers in zip 53590 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958781 | Family Connections Resource Center LLC | Preferred Provider Organization | 6830 W Villard Ave Ste 301, Milwaukee, WI 53218-3968 | 2020-06-30 |
| 1215572409 | Carla L Davis | Preferred Provider Organization | 3709 N. 41st Street, Milwaukee, WI 53216-3044 | 2019-11-12 |
| 1912372418 | Avada Audiology and Hearing Care | Preferred Provider Organization | 813 Fox Lane Suite B, Waterford, WI 53404 | 2015-12-09 |
| 1649668179 | Guiding Hearts Home Health Care | Preferred Provider Organization | 2867 N 45th St, Milwaukee, WI 53210-1714 | 2015-01-07 |
| 1972919314 | Psychological & Hr Consulting LLC | Preferred Provider Organization | 4317 N Stowell Ave, Shorewood, WI 53211-1748 | 2014-07-07 |
| 1598195281 | Rexnord Health and Wellness Center | Preferred Provider Organization | 1301 W Canal St, Suite 200, Milwaukee, WI 53233-2667 | 2013-11-18 |
| 1508296237 | Wps Health and Wellness Center | Preferred Provider Organization | 1707 W Broadway, Monona, WI 53713-1834 | 2013-11-15 |
| 1679907828 | Life Touches Home Healthcare, LLC | Preferred Provider Organization | 4234 N 76th St, Suite A, Milwaukee, WI 53222-2002 | 2013-08-23 |
| 1164763926 | Jannah Home Healthcare | Preferred Provider Organization | 2133 W North Ave, Milwaukee, WI 53205-1133 | 2013-03-04 |
| 1003151366 | The Wellness Way Appleton | Preferred Provider Organization | W3169 Van Roy Rd, Ste #11, Appleton, WI 54915-3985 | 2012-11-27 |
| Find all providers with the same taxonomy | ||||
| City | SUN PRAIRIE |
| Zip Code | 53590 |
Please comment or provide details below to improve the information on STATE MEDICAID.
| 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.