PAIN CENTERS OF WISCONSIN - WEST BEND, LLC (NPI# 1154663904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154663904 |
| Entity Type | Organization |
| Organization Name | PAIN CENTERS OF WISCONSIN - WEST BEND, LLC |
| Practice Address |
1000 Gateway Ct West Bend WI 53095-8541 |
| Mailing Address |
4131 W Loomis Rd Ste 300 Greenfield WI 53221-2057 |
| Practice Telephone | 4143257246 |
| Practice Fax Number | 4143253770 |
| Mailing Telephone | 4143257246 |
| Mailing Fax Number | 4143253770 |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2016-10-24 |
| Authorized Official Name | VISHAL LAL (CEO) |
| Authorized Official Telephone | 4143257246 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407419328 | Pain Centers of Wisconsin - West Bend, LLC | Durable Medical Equipment & Medical Supplies | 1000 Gateway Ct, West Bend, WI 53095-8541 | 2019-04-16 |
| Street Address |
1000 GATEWAY CT |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-8541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407419328 | Pain Centers of Wisconsin - West Bend, LLC | Durable Medical Equipment & Medical Supplies | 1000 Gateway Ct, West Bend, WI 53095-8541 | 2019-04-16 |
| 1720472558 | Advanced Pain Management Sc | Durable Medical Equipment & Medical Supplies | 1000 Gateway Ct, Suite 200, West Bend, WI 53095-8541 | 2015-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113841 | Spine Solutions of West Bend LLC | Clinic/Center | 1000 Gateway Ct Ste 200, West Bend, WI 53095-8541 | 2020-10-29 |
| 1447269790 | West Bend Surgery Center LLC | Clinic/Center | 3212 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2006-08-05 |
| 1962065987 | West Bend Surgery Center LLC | Clinic/Center | 3212 Pleasant Valley Rd, West Bend, WI 53095 | 2019-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205454626 | Eye Surgery Center of Wisconsin, LLC | Clinic/Center | 10148 S 27th St, Oak Creek, WI 51354 | 2020-07-13 |
| 1083242325 | Appleton Surgical Center LLC | Clinic/Center | 1616 N Casaloma Dr # 200, Appleton, WI 54913-8245 | 2020-03-31 |
| 1164056974 | Orthopedic Surgery Center of The Fox Valley LLC | Clinic/Center | 1205 W. American Drive, Neenah, WI 54596-5459 | 2020-03-02 |
| 1013548833 | Ascension Wisconsin Surgery Center-mount Pleasant LLC | Clinic/Center | 10180 Washington Ave Ste 200, Mount Pleasant, WI 53177-1604 | 2020-01-30 |
| 1497393516 | Aurora Surgery Centers, LLC | Clinic/Center | 12500 Aurora Drive, Pleasant Prairie, WI 53158 | 2019-12-19 |
| 1275178444 | Kenosha Digestive Health Center LLC | Clinic/Center | 8220 75th St, Kenosha, WI 53142-7637 | 2019-11-12 |
| 1851887715 | Southern Lakes Endoscopy LLC | Clinic/Center | 240 Maple Ave Ste 2220, Mukwonago, WI 53149-8475 | 2018-07-03 |
| 1447768411 | Wisconsin Institute of Surgical Excellence LLC | Clinic/Center | 1265 W American Dr Ste 200, Neenah, WI 54956 | 2018-01-12 |
| 1629518006 | Great Lakes Surgery LLC | Clinic/Center | 6123 Green Bay Rd Ste 101, Kenosha, WI 53142-2927 | 2017-03-03 |
| 1447799580 | Geneva Surgical Suites, LLC | Clinic/Center | 119 Elizabeth Lane, Genoa City, WI 53128-2124 | 2017-02-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PAIN CENTERS OF WISCONSIN - WEST BEND, LLC.
| 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.