JOEL D PETTY (NPI# 1639212467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639212467 |
| Entity Type | Individual |
| Full Name | JOEL D PETTY |
| Practice Address |
505 Broadway St Baraboo WI 53913-2183 |
| Mailing Address |
329 2nd Ave Baraboo WI 53913-2459 |
| Practice Telephone | 6083554210 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| X | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | PHYSICIANS PLUS | 1025011 | 01 |
| WI | UNITY HEALTH INSURANCE | 39600574011 | 01 |
| WI | 39784200 | 05 | |
| WI | DEAN HEALTH PLAN | 11991 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669434221 | Joel Lee Petty | Physical Therapy Assistant | 1200 N 7th St, Chariton, IA 50049-1210 | 2006-04-06 |
| Street Address |
505 BROADWAY ST |
| City | BARABOO |
| State | WI |
| Zip Code | 53913-2183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508915323 | County of Sauk | Community/Behavioral Health | 505 Broadway St, Baraboo, WI 53913-2183 | 2007-01-10 |
| 1669072625 | Solare Elizabeth O'brien-brethorst | Social Worker | 505 Broadway St, Baraboo, WI 53913-2183 | 2020-10-29 |
| 1710522792 | Sauk County Department of Human Services | Physical Therapist | 505 Broadway St, Baraboo, WI 53913-2183 | 2019-11-13 |
| 1356909139 | Sara Tiffany Graap | Counselor | 505 Broadway St, Baraboo, WI 53913-2183 | 2019-06-05 |
| 1083178230 | Nicole D Morris | Counselor | 505 Broadway St, Baraboo, WI 53913-2183 | 2019-01-22 |
| 1356815872 | Jonathan Michael Ward | Counselor | 505 Broadway St, Baraboo, WI 53913-2183 | 2019-01-17 |
| 1699211656 | Khloe Jean Pierce-bates | Counselor | 505 Broadway St, Baraboo, WI 53913-2183 | 2017-01-16 |
| 1124560263 | Dawn Thompson | Registered Nurse | 505 Broadway St, Baraboo, WI 53913-2183 | 2016-11-07 |
| 1710433255 | Nicole Terrill | Physical Therapist | 505 Broadway St, Baraboo, WI 53913-2183 | 2016-08-25 |
| 1598117335 | Daedre Carlson | Occupational Therapist | 505 Broadway St, Baraboo, WI 53913-2183 | 2016-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407786 | Nordic Private Care, LLC | Clinic/Center | 814 Lynn Avenue, Baraboo, WI 53913 | 2020-11-06 |
| 1467088336 | Malerie Catherine Kurt | Physical Therapist | 707 14th Street, Rehabilitation Department, Baraboo, WI 53913 | 2020-03-23 |
| 1639718174 | Gwendolynn Sue Doyle | Physical Therapy Assistant | 1414 Jefferson Street, Baraboo, WI 53913 | 2020-01-02 |
| 1922572320 | Karen L Elsby | Case Manager/Care Coordinator | Lutheran Social Services of Wi, 727 8th Street, Baraboo, WI 53913 | 2019-01-18 |
| 1952874281 | Cheryl Millard | Social Worker | Lutheran Social Services of Wisconsin, 727 8th Street Lower Level, Baraboo, WI 53913 | 2019-01-09 |
| 1427536598 | Daniel Robert Tokarczyk | Hearing Instrument Specialist | 622 State Hwy 136, Miracle Ear, Baraboo, WI 53913 | 2018-08-01 |
| 1508359928 | Erick Lichte Krueger | Counselor | 840 Us-12 #1, Baraboo, WI 53913 | 2018-06-11 |
| 1003351834 | Jason Welch | Hearing Instrument Specialist | 622 State Rd 136, Baraboo, WI 53913 | 2017-01-03 |
| 1376947820 | Affordable Medfical Transportation Services, Inc. | Non-emergency Medical Transport (VAN) | 1350 Jefferson St., Office, Attn, : Ada Vans, Baraboo, WI 53913 | 2014-10-13 |
| 1609179134 | Barbara Ostrowski | Registered Nurse | 52845 White Eagle Rd, Ho-chunk House of Wellness, Baraboo, WI 53913 | 2010-12-06 |
| Find all providers in zip 53913 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598253890 | Connie Rae Champion | Counselor | 414 Broadway St Ste 101, Baraboo, WI 53913-2488 | 2018-04-23 |
| 1588103709 | Cathy King | Counselor | 209 Blake St, Baraboo, WI 53913-2917 | 2017-02-21 |
| 1639402902 | Innervisions Counseling & Consulting Center, S.c. | Counselor | 840 State Road 136 Ste 1, Baraboo, WI 53913-9252 | 2009-09-17 |
| 1942808589 | Bridget Therese Riley | Counselor | 840 Hwy 136 Ste 1, Baraboo, WI 53913-9252 | 2020-10-15 |
| 1083178230 | Nicole D Morris | Counselor | 505 Broadway St, Baraboo, WI 53913-2183 | 2019-01-22 |
| 1588137673 | Nicole Drier | Counselor | 727 8th St, Baraboo, WI 53913-1794 | 2019-01-10 |
| 1710424544 | Heidi Brianne Schultz | Counselor | 414 Broadway St, Suite 101, Baraboo, WI 53913-2488 | 2017-01-31 |
| 1699211656 | Khloe Jean Pierce-bates | Counselor | 505 Broadway St, Baraboo, WI 53913-2183 | 2017-01-16 |
| 1134672975 | Lisa T Bargender | Counselor | S2845 White Eagle Rd, Baraboo, WI 53913 | 2016-07-28 |
| 1033531108 | Joseph White Eagle Sr. | Counselor | S2845 White Eagle Rd, Baraboo, WI 53913-9064 | 2014-01-09 |
| Find all providers in BARABOO | ||||
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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.