NORTH CENTRAL REGION CCS PROGRAM (NPI# 1043727936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043727936 |
| Entity Type | Organization |
| Organization Name | NORTH CENTRAL REGION CCS PROGRAM |
| Practice Address |
540 College St Medford WI 54451-2027 |
| Practice Telephone | 7157483332 |
| Practice Fax Number | 7157483342 |
| Mailing Telephone | 7157483332 |
| Mailing Fax Number | 7157483342 |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2018-01-16 |
| Authorized Official Name | RHONDA RUDOLPH (BUSINESS MANAGER) |
| Authorized Official Telephone | 7157483332 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 3193 | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42140500 | 05 |
| Street Address |
540 COLLEGE ST |
| City | MEDFORD |
| State | WI |
| Zip Code | 54451-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862386 | Alexandra Belter | Counselor | 540 College St, Medford, WI 54451-2027 | 2019-07-16 |
| 1275191900 | Michelle Lynn Stone | Counselor | 540 College St, Medford, WI 54451-2027 | 2019-05-29 |
| 1720595341 | Taylor County Human Services Department | Clinic/Center | 540 College St, Medford, WI 54451-2027 | 2018-01-04 |
| 1134668049 | Taylor County Human Services Department | Community/Behavioral Health | 540 College St, Medford, WI 54451-2027 | 2017-02-13 |
| 1225404361 | Laurie Hoffman | Counselor | 540 College St, Medford, WI 54451-2027 | 2015-08-12 |
| 1306221957 | Taylor County Human Services | Clinic/Center | 540 College St, Medford, WI 54451-2027 | 2015-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710536321 | Bone & Joint Clinic S.c. | Durable Medical Equipment & Medical Supplies | 724 S. 8th St, Medford, WI 54451 | 2019-09-06 |
| 1215474671 | Heidi Marie Nernberger | Dental Hygienist | 124 S. Main Street, Medford, WI 54451 | 2017-01-24 |
| 1497152656 | Rachel E Nichols | Dental Hygienist | 124 South Main St, Medford, WI 54451 | 2014-12-03 |
| 1811305360 | Amanda Mosse | Social Worker | 10649 W Perkinstown Ave, Medford, WI 54451 | 2014-07-29 |
| 1891081113 | Debra Jeanne Zenner | Nurse Practitioner | 143 South Gibson St., Medford, WI 54451 | 2011-06-24 |
| 1033445036 | Greg George Schoofs II | Ophthalmology | N 4803 Wigwam Ave, Medford, WI 54451 | 2009-10-26 |
| 1558511295 | Aspirus Medford Hospital & Clinics, Inc. | Clinic/Center | 111 S Gibson St, Medford, WI 54451 | 2008-09-30 |
| 1013132430 | Aspirus Medford Hospital & Clinics, Inc. | Pharmacy | 139 S Gibson St, Medford, WI 54451 | 2007-04-13 |
| 1356566707 | Peter G Kiefer | Pharmacist | 139 South Gibson St, Medford, WI 54451 | 2007-04-13 |
| 1851426753 | Steven Todd Dietzman | Specialist/Technologist | 103 South Gibson Street, Medford, WI 54451 | 2007-02-22 |
| Find all providers in zip 54451 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607464 | Rogue Therapy | Community/Behavioral Health | 328 S Central Ave Ste 213, Medford, OR 97501-7274 | 2020-10-24 |
| 1326671082 | Res-care New Jersey, Inc. | Community/Behavioral Health | 268 Hopewell Rd, Medford, NJ 08055-8149 | 2020-02-20 |
| 1346882461 | Catherine Elizabeth Young | Community/Behavioral Health | 46 Park Ln, Medford, NY 11763-1143 | 2019-10-09 |
| 1861927089 | Leslie Rheault, Lpc | Community/Behavioral Health | 2191 Canal St, Medford, OR 97501-4338 | 2017-04-25 |
| 1497280697 | Inspired Wellness LLC | Community/Behavioral Health | 1883 Orangewood Dr, Medford, OR 97504-5727 | 2017-04-25 |
| 1164971354 | Integrative Counseling & Wellness, LLC | Community/Behavioral Health | 328 S Central Ave Ste 203, Medford, OR 97501-7274 | 2016-09-28 |
| 1437504651 | Hearts With A Mission | Community/Behavioral Health | 711 Medford Ctr # 334, Medford, OR 97504-6772 | 2016-04-25 |
| 1932568425 | Wellness Psychology, LLC | Community/Behavioral Health | 3228 Hillcrest Park Dr, Medford, OR 97504-7657 | 2016-02-12 |
| 1164811873 | Alice M. Jannini Counseling Services, LLC | Community/Behavioral Health | 500 Stokes Rd, Suite B-5, Medford, NJ 08055-2920 | 2015-01-19 |
| 1609292069 | Mindie A Medina | Community/Behavioral Health | 1005 E. Main St, Medford, OR 97504 | 2014-03-10 |
| Find all providers in MEDFORD | ||||
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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.