INTEGRATIVE HEALTH CENTER OF CENTRAL WISCONSIN LLC (NPI# 1255974952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255974952 |
| Entity Type | Organization |
| Organization Name | INTEGRATIVE HEALTH CENTER OF CENTRAL WISCONSIN LLC |
| Other Organization Name | INTEGRATIVE HEALTH CENTER OF CENTRAL WISCONSIN LLC |
| Practice Address |
3205 E Washington Ave Ste A Madison WI 53704-4332 |
| Practice Telephone | 6082222700 |
| Practice Fax Number | 6082222771 |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2020-01-20 |
| Authorized Official Name | JONATHAN COTTER (OWNER) |
| Authorized Official Telephone | 6082222700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34668700 | 05 |
| Other Name | Type Code |
|---|---|
| Integrative Health Center of Central Wisconsin LLC | Doing Business As Name - Organization |
| Street Address |
3205 E WASHINGTON AVE STE A |
| City | MADISON |
| State | WI |
| Zip Code | 53704-4332 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159998 | Beam Healthcare, Sc | Family Medicine | 25 W Main St Fl 5, Madison, WI 53703-3399 | 2020-06-18 |
| 1598390932 | Ashley Rae Woodcock | Family Medicine | 844 Slaughter Rd, Madison, AL 35758-8836 | 2020-03-05 |
| 1538628961 | Heidi Hollinger | Family Medicine | 145 Kelso Blvd, Madison, AL 35756-4285 | 2019-03-15 |
| 1902364383 | Robert Thomas Pepper | Family Medicine | 1740 Lions Club Rd Ste 100, Madison, GA 30650-4762 | 2019-03-05 |
| 1497240485 | Doctor-patient Medicine Inc | Family Medicine | 101 Westover Cir Ste B, Madison, AL 35758-4900 | 2018-06-22 |
| 1457863243 | Debra Ann Mandarino | Family Medicine | 4223 Mandan Cres # 4223, Madison, WI 53711-3063 | 2017-11-02 |
| 1407367683 | Roxanne L Brown | Family Medicine | 1210 Briarville Rd Bldg F, Madison, TN 37115-5136 | 2017-10-16 |
| 1871023242 | Tulio Romulo Figarola | Family Medicine | 225 Mill Walk Ct, Madison, AL 35758-1565 | 2017-06-18 |
| 1649704586 | Zaunklay Finnila | Family Medicine | 540 Hughes Rd Ste 4, Madison, AL 35758-8959 | 2017-04-18 |
| 1861846313 | David Green | Family Medicine | 102 Lexington Drive, Suite 100, Madison, MS 39110 | 2016-04-21 |
| Find all providers in MADISON | ||||
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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.