BADGER IOM, LLC (NPI# 1730680539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730680539 |
| Entity Type | Organization |
| Organization Name | BADGER IOM, LLC |
| Practice Address |
4321 W College Ave Suite 200 Appleton WI 54914 |
| Practice Telephone | 9202123253 |
| Mailing Telephone | 9202123253 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | FELICIA ALDERETE (LEGAL OPS MANAGER) |
| Authorized Official Telephone | 2105982800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204R00000X | Electrodiagnostic Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
Allopathic & Osteopathic Physicians |
| Street Address |
4321 W COLLEGE AVE SUITE 200 |
| City | APPLETON |
| State | WI |
| Zip Code | 54914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841234937 | Timothy S Chen | Radiology | 4321 W College Ave, Ste 300, Appleton, WI 54914-3966 | 2006-06-16 |
| 1629683487 | Central Orthopedic Network, LLC | Durable Medical Equipment & Medical Supplies | 4321 W College Ave, Appleton, WI 54914-3966 | 2020-09-09 |
| 1144858895 | Venvisor Health Wisconsin LLC | Nurse Practitioner | 4321 W College Ave, Ste 200, Appleton, WI 54914-3968 | 2020-03-30 |
| 1558614925 | Prn Health Services, Inc. | Nursing Care | 4321 W College Ave, Suite 200, Appleton, WI 54914-3966 | 2012-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572429 | Claire Schuh | Social Worker | 3416 Association Ln, Appleton, WI 54914 | 2020-09-09 |
| 1568099729 | Access Elevator, Inc. | Contractor | 1314 W. College Ave, Appleton, WI 54914 | 2020-03-26 |
| 1124677885 | Sharon Darla Cornell | Technician | 3117 N. Mistwood Lane, Appleton, WI 54914 | 2019-09-05 |
| 1235647793 | Midwest Monitoring, LLC | Psychiatry & Neurology | 4321 W College Ave Ste 200, Appleton, WI 54914 | 2018-01-18 |
| 1356863252 | Uvanta Pharmacy LLC | Pharmacy | 1050 S Grider St, Suite C, Appleton, WI 54914 | 2017-07-12 |
| 1255860912 | Appleton Counseling Management LLC | Counselor | 477 S Nicolet Rd., Appleton, WI 54914 | 2017-06-07 |
| 1609269489 | Shane Scott Urban | Social Worker | 444 N. Westhill Blvd., Appleton, WI 54914 | 2015-03-18 |
| 1699184580 | Michelle Becker | Nurse Practitioner | 4435 West Lawrence St., Appleton, WI 54914 | 2014-08-05 |
| 1972857514 | Jean Flesch | Pharmacist | 1000 W. Northland Ave., Appleton, WI 54914 | 2012-11-05 |
| 1477845147 | Mallory Barbara Herrin | Counselor | 820 W. College Ave, Appleton, WI 54914 | 2011-05-12 |
| Find all providers in zip 54914 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659511780 | Center for Neurology & Sleep Disorders, Sc | Psychiatry & Neurology | 240 Regency Ct, Suite 201, Brookfield, WI 53045-6162 | 2009-03-03 |
| 1285802413 | Insight Neuralmonitoring, Inc. | Psychiatry & Neurology | N17w24222 Riverwood Dr, Suite 190, Waukesha, WI 53188-1132 | 2008-02-11 |
| 1508878422 | Rakesh J Shah | Psychiatry & Neurology | 190 Gardner Ave, Suite 3, Burlington, WI 53105-2160 | 2006-08-12 |
| 1770886392 | Vigilant Partners, S.c. | Psychiatry & Neurology | 318 Park Dr, Neenah, WI 54956-2899 | 2010-12-21 |
| 1194963504 | Neurology Alliance S.c. | Psychiatry & Neurology | 2424 S 90th St, Suite 504, West Allis, WI 53227-2455 | 2009-01-23 |
| 1508939976 | John Scott Broderick | Psychiatry & Neurology | 13133 N Port Washington Rd, Suite G06, Mequon, WI 53097-2419 | 2006-11-15 |
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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.