STATE OF WISCONSIN (NPI# 1336324946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336324946 |
| Entity Type | Organization |
| Organization Name | STATE OF WISCONSIN |
| Other Organization Name | REHABILIATION SERVICES |
| Practice Address |
317 Knutson Dr Madison WI 53704-1133 |
| Practice Telephone | 6083019382 |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2016-01-26 |
| Authorized Official Name | KIMBERLY A COPLIEN (DIRECTOR OF REHABILITATION SERVICES) |
| Authorized Official Telephone | 6083019382 |
| Authorized Official Credential | PT, DPT |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRAL WISCONSIN CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41225300 | 05 |
| Other Name | Type Code |
|---|---|
| Rehabiliation Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558615815 | State of Wisconsin | Skilled Nursing Facility | 2175 E Park Ave, Chippewa Falls, WI 54729-3511 | 2012-11-07 |
| 1225152861 | State of Wisconsin | Skilled Nursing Facility | 21425g Spring St, Union Grove, WI 53182-9707 | 2007-03-19 |
| 1235225616 | State of Wisconsin | Intermediate Care Facility, Mentally Retarded | 2820 East Park Avenue, Chippewa Falls, WI 54729-0340 | 2006-10-05 |
| 1366439986 | State of Wisconsin | Skilled Nursing Facility | N2665 County Road Qq, King, WI 54946 | 2005-09-29 |
| 1225362403 | State of Wisconsin | Durable Medical Equipment & Medical Supplies | 317 Knutson Dr, Madison, WI 53704-1133 | 2009-09-22 |
| 1588703078 | State of Wisconsin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 317 Knutson Dr, Madison, WI 53704-1133 | 2007-02-05 |
| 1386705655 | State of Wisconsin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 317 Knutson Dr, Madison, WI 53704-1133 | 2006-12-12 |
| 1164516506 | State of Wisconsin | Psychiatric Hospital | 1300 South Drive, Winnebago, WI 54985-0009 | 2006-10-02 |
| 1437253648 | State of Wisconsin | General Acute Care Hospital | 301 Troy Dr, Madison, WI 53704-1521 | 2006-09-08 |
| 1043326747 | State of Wisconsin | Intermediate Care Facility, Mentally Retarded | 21425 Spring St, Union Grove, WI 53182-9707 | 2006-08-22 |
| Street Address |
317 KNUTSON DR |
| City | MADISON |
| State | WI |
| Zip Code | 53704-1133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639174782 | Cari A Eggert | Physical Medicine & Rehabilitation | 317 Knutson Dr, Central Wisconsin Center, Madison, WI 53704-1133 | 2005-06-16 |
| 1588223424 | Alexandra Williams | Pharmacist | 317 Knutson Dr, Madison, WI 53704-1133 | 2019-06-12 |
| 1154835411 | Ashley Marie Alagna | Physical Therapist | 317 Knutson Dr, Madison, WI 53704-1133 | 2017-11-24 |
| 1891208534 | Sarah Wilkin | Occupational Therapist | 317 Knutson Dr, Madison, WI 53704-1133 | 2017-11-15 |
| 1396256038 | Abigail Marie Quamme | Physical Therapy Assistant | 317 Knutson Dr, Madison, WI 53704-1133 | 2017-10-21 |
| 1174043392 | Kris A Moeller | Occupational Therapist | 317 Knutson Dr, Madison, WI 53704-1133 | 2017-06-20 |
| 1952783706 | Theresa Murray | Physical Therapist | 317 Knutson Dr, Central Wisconsin Center, Pt/ot Rehab Department, Madison, WI 53704-1133 | 2015-06-28 |
| 1770964264 | Tegan Corrigan | Psychologist | 317 Knutson Dr, Madison, WI 53704-1133 | 2015-06-10 |
| 1689071599 | Clare Weege | Pharmacist | 317 Knutson Dr, Madison, WI 53704-1133 | 2014-11-21 |
| 1376974428 | Chelsea Cox | Physical Therapist | 317 Knutson Dr, Madison, WI 53704-1133 | 2013-11-27 |
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| 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 | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020616 | Viaquest Healthcare Central | Intermediate Care Facility, Mentally Retarded | 6873 Dave Dr, Madison, OH 44057-1105 | 2020-10-15 |
| 1508080680 | New Avenues To Independence, Inc. | Intermediate Care Facility, Mentally Retarded | 5051 S Ridge Rd, Madison, OH 44057-9709 | 2007-04-12 |
| 1831218262 | Voca of Indiana LLC | Intermediate Care Facility, Mentally Retarded | 3004 Kentucky Ave, Madison, IN 47250 | 2007-03-28 |
| 1437277555 | Rescare Inc | Intermediate Care Facility, Mentally Retarded | 402 Presbyterian Ave, Madison, IN 47250-3333 | 2007-03-27 |
| 1457415341 | Rescare | Intermediate Care Facility, Mentally Retarded | 330 Jackson Ave, Madison, WV 25130-1318 | 2006-12-22 |
| 1033286190 | Miller Holdings Stewart, Inc. | Intermediate Care Facility, Mentally Retarded | 7774 Warner Rd, Madison, OH 44057-9547 | 2006-11-30 |
| 1891393344 | Viaquest Healthcare Central | Intermediate Care Facility, Mentally Retarded | 3142 County Line Rd, Madison, OH 44057-9705 | 2020-10-15 |
| 1487252037 | Viaquest Healthcare Central | Intermediate Care Facility, Mentally Retarded | 2243 Cambrian Way, Madison, OH 44057-2409 | 2020-10-15 |
| 1396378535 | Viaquest Healthcare Central | Intermediate Care Facility, Mentally Retarded | 5278 Lockwood Rd, Madison, OH 44057-2313 | 2020-02-17 |
| 1780043588 | Living Opportunities | Intermediate Care Facility, Mentally Retarded | 3142 County Line Rd, Madison, OH 44057-9705 | 2016-02-22 |
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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.