NPIMap

Organization Active NPI

Ams of Wisconsin, LLC

  • Methadone Clinic
  • Onalaska, WI
National Provider Identifier
1003150004
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
2971 Issued in WI
Legal business name
AMS OF WISCONSIN, LLC
Practice address
9532 E 16 Frontage Rd
Suite 100
Onalaska, WI 54650-6739
Phone
(608) 783-0506
Fax
(608) 783-0242
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael Errico, MS
Title
President
Phone
(608) 783-0506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 2971 WI Primary

Addresses

Primary practice location

9532 E 16 Frontage Rd
Suite 100
Onalaska, WI 54650-6739

Mailing address

9532 E 16 Frontage Rd
Suite 100
Onalaska, WI 54650-6739
Phone (608) 783-0506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201009000354 WI Part B Supplier - Opioid Treatment Program (Otp) 7618303165 1 other NPI on this enrollment
Practice locations: Onalaska, WI; Oshkosh, WI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ams of Wisconsin-Janesville LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9532 E 16 Frontage Rd
Ste 100
Onalaska, WI 54650
Phone (608) 783-0506

505 S Washburn St
Oshkosh, WI 54904
Phone (920) 232-2332

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 47

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632441600000",
    "number": "1003150004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9532 E 16 FRONTAGE RD",
            "address_2": "SUITE 100",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546506739",
            "telephone_number": "608-783-0506",
            "fax_number": "608-783-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9532 E 16 FRONTAGE RD",
            "address_2": "SUITE 100",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546506739",
            "telephone_number": "608-783-0506",
            "fax_number": "608-783-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMS OF WISCONSIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A",
        "authorized_official_last_name": "ERRICO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-783-0506",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "WI",
            "license": "2971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.