Promed Preferred Wi SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROMED PREFERRED WI SC

Practice address

155 2ND St S
Hudson, WI 54016-2234

Phone

(615) 499-3165

NPI assigned

Sep 30, 2024

Organization subpart

No

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

Authorized official

Name

Lev Grinman, MD

Title

Owner

Phone

(615) 499-3165

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1013735802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 S OYSTER BAY RD STE 2059",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 2ND ST S",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540162234",
            "telephone_number": "615-499-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED PREFERRED WI SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "GRINMAN",
        "authorized_official_first_name": "LEV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-499-3165",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Joanne Pratts, PT
• Olivia Christina Preston, PHD
• Kara Jo Prestrud, CD(DONA)
• Katherine Rose Priebe, PSY.D., P.C
• Heather Marie Printz, OTR/L
• Katherine M Prozeller, PSYD, MA, MBA
• Lisa Pulkrabek Juettner, RN
• James David Purdy, D.D.S.
• Kimberly Marie Quayle, OTR
• Wafa A Qureshi, DDS

• Family Medicine Physician in Hudson, WI
• Providers in Hudson, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.