INTERVENTIONAL PAIN SPECIALISTS OF WISCONSIN, SC (NPI# 1992800791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992800791 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL PAIN SPECIALISTS OF WISCONSIN, SC |
| Practice Address |
2021 Cenex Dr Suite J Rice Lake WI 54868-1891 |
| Practice Telephone | 7152347246 |
| Practice Fax Number | 7152347242 |
| Mailing Telephone | 7152347246 |
| Mailing Fax Number | 7152347242 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOHN K BRENDEL JR. (OWNER) |
| Authorized Official Telephone | 7152347246 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
34036 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31913700 | 05 | |
| WI | WI LICENSE NUMBER | 34036 | 01 |
| WI | DEA | BB3535842 | 01 |
| WI | BLUE CROSS WI | 397524621000 | 01 |
| Street Address |
2021 CENEX DR SUITE J |
| City | RICE LAKE |
| State | WI |
| Zip Code | 54868-1891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710322540 | Stephens Chiropractic, S.c. | Chiropractor | 2021 Cenex Dr, Ste E, Rice Lake, WI 54868-1891 | 2013-05-07 |
| 1396006771 | Merilee M Lapoint | Nurse Practitioner | 2021 Cenex Dr, Suite K, Rice Lake, WI 54868-1891 | 2012-06-02 |
| 1831419167 | Accuquest Hearing Center | Clinic/Center | 2021 Cenex Dr, Rice Lake, WI 54868-1891 | 2010-06-09 |
| 1699864108 | Jason Todd Stephens | Chiropractor | 2021 Cenex Dr, Suite E, Rice Lake, WI 54868-1891 | 2006-10-12 |
| 1295833507 | Carol Matthys | Nurse Practitioner | 2021 Cenex Dr, Suite J, Rice Lake, WI 54868-1891 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073170791 | Samantha Barg | Physical Therapist | 1035 N. Main Street, Rice Lake, WI 54868 | 2019-05-29 |
| 1023597531 | Alison Joe Thorpe | Respite Care | 336 Gerland Rd, Rice Lake, WI 54868 | 2018-08-07 |
| 1669997946 | Char Mlejnek | Registered Nurse | 1700 W. Stout Street, Rice Lake, WI 54868 | 2017-08-08 |
| 1801344650 | Cumberland Memorial Hospital Inc | Occupational Therapist | 1895 20 1/2 Avenue, Rice Lake, WI 54868 | 2016-09-21 |
| 1851849814 | Leroy A Odden | Registered Nurse | 2135 20 1/8 Ave, Rice Lake, WI 54868 | 2016-09-19 |
| 1871903799 | Courtney Lange | Occupational Therapist | 910 Bear Paw Avenue, Rice Lake, WI 54868 | 2014-04-30 |
| 1063859130 | Mikeal Robert Ostrander | Optometrist | 320 County Highway O, Shopko Optical, Rice Lake, WI 54868 | 2013-05-30 |
| 1487976239 | Dale Henry Pracht | Pharmacist | 2601 South Main St, Kmart Pharmacy, Rice Lake, WI 54868 | 2010-02-22 |
| 1104159870 | Dianne Marie Thompson | Hearing Instrument Specialist | 212 S. Main St., Rice Lake, WI 54868 | 2009-09-14 |
| 1760646806 | Lori Ann Click Gray | Pediatrics | 736 Pine Place, Rice Lake, WI 54868 | 2008-07-17 |
| Find all providers in zip 54868 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700309101 | Wisconsin Interventional Pain Solutions Sc | Anesthesiology | 2500 N Mayfair Rd Ste 325, Wauwatosa, WI 53226-1443 | 2017-07-18 |
| 1528402781 | Aspen Wellness and Pain Medicine Center | Anesthesiology | W176n9830 Rivercrest Dr Ste 102, Germantown, WI 53022-4692 | 2013-04-18 |
| 1720307283 | Andres Fernando Quitzon Jr. | Anesthesiology | 2245 W Brantwood Ave, Milwaukee, WI 53209 | 2010-05-24 |
| 1861688418 | Horizon Interventional Pain Physicians, Sc | Anesthesiology | 7071 S 13th St, Suite # 102, Oak Creek, WI 53154-1466 | 2007-09-18 |
| 1275500910 | Saleem Awan | Anesthesiology | 4570 S 27th St, Milwaukee, WI 53221-2145 | 2006-03-01 |
| 1871560581 | Yogendra Bharat | Anesthesiology | 2500 W Layton Ave Ste 170, Milwaukee, WI 53221-5433 | 2006-03-01 |
| 1871569830 | Roman Berezovski | Anesthesiology | 4131 W. Loomis Rd., Ste 300, Greenfield, WI 53221-2059 | 2006-02-28 |
| 1598762841 | Nathan C Meloy | Anesthesiology | 2700 W 9th Ave, Suite 205, Oshkosh, WI 54904-7247 | 2005-07-01 |
| 1922457803 | Holly Haberman | Anesthesiology | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2016-06-10 |
| 1639531650 | Braden Woodhouse Jex | Anesthesiology | 9200 W Wisconsin Ave, P348, Milwaukee, WI 53226-3522 | 2016-03-28 |
| Find all providers with the same taxonomy | ||||
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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.