FORT HEALTHCARE INC (NPI# 1720148182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720148182 |
| Entity Type | Organization |
| Organization Name | FORT HEALTHCARE INC |
| Other Organization Name | FORT MEDICAL GROUP MADISON |
| Practice Address |
402 Gammon Pl Suite 380 Madison WI 53719-1045 |
| Practice Telephone | 6088336905 |
| Practice Fax Number | 6088332921 |
| Mailing Telephone | 6088336905 |
| Mailing Fax Number | 6088332921 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES NELSON (VP CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9205685000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42237700 | 05 |
| Other Name | Type Code |
|---|---|
| FORT MEDICAL GROUP MADISON | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598826489 | Fort Healthcare Inc | Urology | 520 Handeyside Ln, Ste 2, Fort Atkinson, WI 53538-1277 | 2006-12-13 |
| 1417450115 | Fort Healthcare Inc | Family Medicine | 500 Mcmillen St, Fort Atkinson, WI 53538-1233 | 2018-03-09 |
| 1215255435 | Fort Healthcare Inc | Orthopaedic Surgery | 1504 Madison Ave, Fort Atkinson, WI 53538-3100 | 2010-05-12 |
| 1629287180 | Fort Healthcare Inc | Pediatrics | 500 Mcmillen St, Fort Atkinson, WI 53538-1233 | 2007-05-22 |
| 1831252196 | Fort Healthcare Inc | Social Worker | 509 Mcmillen St, Fort Atkinson, WI 53538-1263 | 2006-12-18 |
| 1669533840 | Fort Healthcare Inc | Otolaryngology | 512 Wilcox St, Fort Atkinson, WI 53538-1254 | 2006-12-12 |
| 1861552218 | Fort Healthcare Inc | Family Medicine | 840 W Racine St, Jefferson, WI 53549-1053 | 2006-12-08 |
| 1952461311 | Fort Healthcare Inc | Urology | 20 N Church St, Elkhorn, WI 53121-1770 | 2006-12-08 |
| 1083623383 | Fort Healthcare Inc | Psychologist | 400 Doctors Ct, Johnson Creek, WI 53038-9567 | 2006-08-05 |
| 1417993361 | Fort Healthcare Inc | Psychologist | 611 Sherman Ave E, Fort Atkinson, WI 53538-1960 | 2006-06-21 |
| Street Address |
402 GAMMON PL SUITE 380 |
| City | MADISON |
| State | WI |
| Zip Code | 53719-1045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558339713 | Lucinda C Thimm-jurado | Counselor | 402 Gammon Pl, Suite 290, Madison, WI 53719-1045 | 2006-03-14 |
| 1053586453 | Mental Health Resources | Counselor | 402 Gammon Pl, Suite 290, Madison, WI 53719-1045 | 2008-04-25 |
| 1437285418 | Susan Marie Neff | Registered Nurse | 402 Gammon Pl, Suite 290, Madison, WI 53719-1045 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271801 | Jessica Seidel | Registered Nurse | 1015 Gammon Lane, Madison, WI 53719 | 2020-10-01 |
| 1376168989 | 360 Wellness LLC | Physical Therapist | 504 S Yellowstone Lane, Madison, WI 53719 | 2020-06-09 |
| 1932744067 | Sara Ruiz | Marriage & Family Therapist | Clock Tower Office Park, 6333 Odana Rd, #20, Madison, WI 53719 | 2019-11-13 |
| 1700436466 | David R. Gosling | Counselor | 702 South High Point Road #209, Madison, WI 53719 | 2019-09-16 |
| 1285289587 | Clifton Leo Davis Jr. | Counselor | 6417 O Dana Rd #5, Madison, WI 53719 | 2019-08-05 |
| 1679127278 | Akillah Jamillah Wali | Psychologist | 6417 Odana Rd Suite 5, Madison, WI 53719 | 2019-07-31 |
| 1689230211 | Brandy Georgecopeland | Marriage & Family Therapist | 6417 Odana Rd. Ste 5, Madison, WI 53719 | 2019-05-20 |
| 1275016826 | Kelsey Andersen | Physical Therapist | 504 S. Yellowstone Lane, Madison, WI 53719 | 2018-09-10 |
| 1740797190 | Catelyn Schwerke | Social Worker | 3848 Maple Grove Dr, Apt 307, Madison, WI 53719 | 2018-01-08 |
| 1922519008 | Mary Jane Cruz Delorme | Registered Nurse | 6831 Mader Dr. #210, #210, Madison, WI 53719 | 2017-10-17 |
| Find all providers in zip 53719 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073138327 | Rachel Kahn | Psychologist | 501 Acacia Ln, Madison, WI 53716-3238 | 2020-06-12 |
| 1700363652 | Capital City Psychology, LLC | Psychologist | 313 Price Pl Ste 210, Madison, WI 53705-3262 | 2018-07-24 |
| 1093222010 | Leya Moore | Psychologist | 1415 Rutledge St, Madison, WI 53703-3834 | 2017-12-29 |
| 1306359591 | Elizabeth Gaebler | Psychologist | 700 Ray O Vac Dr Ste 114, Madison, WI 53711-2468 | 2017-11-09 |
| 1619489135 | Streicher-bremer Psychotherapy Sc | Psychologist | 1619 Monroe St Ste 2, Madison, WI 53711-2063 | 2017-10-25 |
| 1356736565 | Madison Behavioral Psychology, LLC | Psychologist | 7818 Big Sky Dr Ste 210, Madison, WI 53719-3524 | 2015-04-03 |
| 1457756595 | Familypath Autism Services, LLC | Psychologist | 575 Donofrio Dr Ste 101, Madison, WI 53719-2832 | 2014-10-31 |
| 1104184142 | Hurd Counseling and Educational Psychology | Psychologist | 700 Rayovac Drive, Madison, WI 53711 | 2012-04-27 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1225342280 | Daniel P. Davis | Psychologist | 7601 Ganser Way, 2nd Floor Suite, Madison, WI 53719-2074 | 2010-08-02 |
| 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.