PRIVATE DUTY NURSING SERVICE (NPI# 1154754620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154754620 |
| Entity Type | Organization |
| Organization Name | PRIVATE DUTY NURSING SERVICE |
| Practice Address |
1538 Troy Dr Apt 1 Madison WI 53704-2074 |
| Practice Telephone | 2313438538 |
| Mailing Telephone | 2313438538 |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2013-08-20 |
| Authorized Official Name | MUSTAPHA KAMBI (REGISTERED) |
| Authorized Official Telephone | 2313438538 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
19433930 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 2241974 | 05 |
| Street Address |
1538 TROY DR APT 1 |
| City | MADISON |
| State | WI |
| Zip Code | 53704-2074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881029304 | Mustapha Kambi | Registered Nurse | 1538 Troy Dr Apt 1, Madison, WI 53704-2074 | 2013-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407369614 | Joseph Michael Oakley II | Chiropractor | 2801 International Ln Ste 102, Madison, WI 53704 | 2017-11-09 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1831554021 | Gideon Kazah | Licensed Practical Nurse | 2488 Dahle Street, Madison, WI 53704 | 2015-12-15 |
| 1174952220 | Group Health Cooperative of South Central Wisconsin Madison College | Durable Medical Equipment & Medical Supplies | 1705 Hoffman Street, Madison, WI 53704 | 2013-11-08 |
| 1407190127 | Ashley Marie Snyder | Social Worker | 5203 Autumn Leaf Lane, Apt. 389, Madison, WI 53704 | 2012-11-19 |
| 1619230638 | Dawn Lynette Butts | Optometrist | 4208 E Washington Ave, Madison, WI 53704 | 2012-06-25 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1578730412 | St. Charles Youth & Family Services | Community Based Residential Treatment Facility, Mental Illness | 310 Troy Dr, Cottage B, Madison, WI 53704 | 2008-05-09 |
| 1538346960 | Elizabeth Ann Reiser-loeber | Dentist | 1001 N. Sherman Ave, Madison, WI 53704 | 2008-01-28 |
| 1861683088 | Stephen Dale Flach | Internal Medicine | Covance, 3402 Kinsman Blvd, Madison, WI 53704 | 2007-08-05 |
| Find all providers in zip 53704 | ||||
| Taxonomy Code | 3140N1450X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| Specialization | Nursing Care, Pediatric |
| A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154869410 | Jacksonscott2 | Skilled Nursing Facility | 4573 N. 22nd Street, Milwaukee, WI 53209 | 2017-02-07 |
| 1720450125 | Independent Nursing | Skilled Nursing Facility | 143 E Pine Hollow Ln Apt 1, Oak Creek, WI 53154-7714 | 2015-10-24 |
| 1528472024 | Colleen L Biller | Skilled Nursing Facility | 1421 S 17th St, Sheboygan, WI 53081-5123 | 2014-06-12 |
| 1023367612 | Johnnie Mae Simmons | Skilled Nursing Facility | 4560 N. 40th St, Milwaukee, WI 53209 | 2012-08-29 |
| 1629302872 | Ashley Zimdahl | Skilled Nursing Facility | N2364 Sunset Dr, Campbellsport, WI 53010-2038 | 2009-09-21 |
| 1760634729 | Regina Angela Lanza | Skilled Nursing Facility | W193s7842 Overlook Bay Rd # 6d, Muskego, WI 53150-7813 | 2008-10-21 |
| 1881865012 | Lisa Salaway | Skilled Nursing Facility | 510 Cabrillo Ct, Verona, WI 53593-8233 | 2008-03-16 |
| 1538353982 | Wisconsin Medicaid | Skilled Nursing Facility | 1528 Remington Rd, Neenah, WI 54956-1696 | 2007-08-29 |
| 1336340561 | Badgerland Billing LLC | Skilled Nursing Facility | 2632 Smithfield Dr, Fitchburg, WI 53719-1665 | 2007-05-28 |
| 1356303101 | Jeannette Ponder | Skilled Nursing Facility | 3152 N 24th Pl, Milwaukee, WI 53206-1209 | 2006-04-06 |
| Find all providers with the same taxonomy | ||||
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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.