NEUROTECH, LLC (NPI# 1912560772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912560772 |
| Entity Type | Organization |
| Organization Name | NEUROTECH, LLC |
| Practice Address |
117 Ne Trilein Dr Ste 202 Ankeny IA 50021-2082 |
| Mailing Address |
626 W Moreland Blvd Waukesha WI 53188-2433 |
| Practice Telephone | 2628756626 |
| Practice Fax Number | 2627540897 |
| Mailing Telephone | 2628756572 |
| Mailing Fax Number | 2627540897 |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-04-17 |
| Authorized Official Name | KRISTINE LISA WILDNER (DIRECTOR OF CONTRACTING & RESEARC) |
| Authorized Official Telephone | 2628756572 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246ZE0500X |
Specialist/Technologist, Other Specialization: EEG |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Neurotech Nebraska | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245793447 | Neurotech, LLC | Specialist/Technologist, Other | 90 Court St Ste 211b, Middletown, CT 06457-3334 | 2019-04-13 |
| 1194283341 | Neurotech, LLC | Technician, Other | 1440 Rockside Rd Ste 315, Parma, OH 44134-2749 | 2019-03-06 |
| 1194289603 | Neurotech, LLC | Technician, Other | 2120 44th St Se Ste 202, Kentwood, MI 49508-5321 | 2019-01-29 |
| 1811451925 | Neurotech, LLC | Technician, Other | 520 Grand Central Ave Unit 204-b, Vienna, WV 26105-2187 | 2019-01-23 |
| 1891259065 | Neurotech, LLC | Specialist/Technologist, Other | 1691 Town Center St, Aurora, IL 60504-4590 | 2019-01-22 |
| 1265903710 | Neurotech, LLC | Technician, Other | 2255 W Laskey Rd Ste A-2, Toledo, OH 43613-3573 | 2018-12-10 |
| 1447735451 | Neurotech, LLC | Specialist/Technologist, Other | 1820 Ridge Rd Ste 303a, Homewood, IL 60430-1759 | 2018-09-26 |
| 1942795190 | Neurotech, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1263 Main St Ste 213, Green Bay, WI 54302-1341 | 2018-06-28 |
| 1649763756 | Neurotech, LLC | Specialist/Technologist, Other | 1691 Town Center St Ste 105, Aurora, IL 60504-4589 | 2018-06-13 |
| 1679064638 | Neurotech, LLC | Clinic/Center | 4609 Mill Branch Ln, Knoxville, TN 37938-3260 | 2018-05-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Neurotech, LLC | 626 W. Moreland Blvd, Waukesha, WI 53188 |
| System for Award Management (SAM) Entities | NEUROTECH, LLC | 626 W Moreland Blvd, Waukesha, WI 53188-2433 |
| Washington State Corporations | NEUROTECH, LLC | 2510 N Pines Rd, Suite 5, Spokane Vly, WA 99206-7636 |
| Street Address |
117 NE TRILEIN DR STE 202 |
| City | ANKENY |
| State | IA |
| Zip Code | 50021-2082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265085450 | Neurotech, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 117 Ne Trilein Dr Ste 202, Ankeny, IA 50021-2082 | 2019-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851856298 | Amy Jo Coenen | Physical Therapy Assistant | 710 East 1st Street, Ankeny, IA 50021 | 2019-02-08 |
| 1073006847 | Kylie Linn Shear | Behavior Technician | 1555 Se Deleware, Ankeny, IA 50021 | 2018-06-07 |
| 1174013445 | Maxwell Sando | Psychologist | 250 Ne 41st Unit 260, Ankeny, IA 50021 | 2018-05-12 |
| 1235638537 | Bria Lynn Colyer | Massage Therapist | 104 Ne 46th Lane Number 9, Ankeny, IA 50021 | 2018-02-02 |
| 1134485998 | Leslie R. Fenimore | Nurse Practitioner | 800 1st Avenue, Mercy North Clinic, Ankeny, IA 50021 | 2012-04-05 |
| 1063713667 | Lori Eisbrener | Counselor | 2525 N Ankeny Blvd, Ste 113, Ankeny, IA 50021 | 2010-11-12 |
| 1679899355 | Rcf Youth Project | Community/Behavioral Health | 738 Ne 8th Street, Ankeny, IA 50021 | 2010-04-20 |
| 1437320595 | Iowa Sleep Disorders Center, P.C. | Clinic/Center | 400 Se Delaware Ave, Ankeny, IA 50021 | 2008-03-17 |
| 1558553891 | Center for Interpersonal Effectiveness, PC | Community/Behavioral Health | 2525 N. Ankeny Blvd., Ste 113, Ankeny, IA 50021 | 2007-08-10 |
| 1295850196 | Stacy Burns Young | Speech-Language Pathologist | 301 Ne Trilein, Suite 4, Ankeny, IA 50021 | 2007-03-20 |
| Find all providers in zip 50021 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639727662 | Idx Technologies Inc. | Physiological Laboratory | 2300 Oakdale Blvd, Coralville, IA 52241-9702 | 2019-09-03 |
| 1982063921 | Braincare, LLC | Physiological Laboratory | 6165 Nw 86th St Ste 130, Johnston, IA 50131 | 2016-02-18 |
| 1992784185 | Midwest Sleep Services, Inc. | Physiological Laboratory | 527 Park Ln, Suite 400, Waterloo, IA 50702-5236 | 2006-01-16 |
| 1770927808 | Btx Iowa Inc | Physiological Laboratory | 3160 8th St Sw Ste C, Altoona, IA 50009-1023 | 2013-04-19 |
| 1982654281 | Diagnostic Health Corporation | Physiological Laboratory | 2600 Grand Ave, Suite 140, Des Moines, IA 50312-5375 | 2006-05-10 |
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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.