Organization Active NPI

Dean Health Systems, Inc.

Doing business as SSM Health Davis Duehr Dean Eye Care - Whitewater

  • Durable Medical Equipment & Medical Supplies
  • Whitewater, WI
National Provider Identifier
1063458354
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DEAN HEALTH SYSTEMS, INC.
Doing business as
SSM Health Davis Duehr Dean Eye Care - Whitewater
Practice address
128 N Tratt St
Whitewater, WI 53190-1205
Phone
(262) 473-4514
Fax
(262) 473-3161
NPI assigned
Jun 22, 2006
Last updated
Aug 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
Amy J Grinnell
Title
Vice President - Finance
Phone
(608) 260-3586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X WI Primary

Addresses

Primary practice location

128 N Tratt St
Whitewater, WI 53190-1205

Mailing address

128 N Tratt St
Whitewater, WI 53190-1205
Phone (262) 473-4514

Other identifiers 1

IdentifierTypeStateIssuer
1053358846MedicaidWI

Other names 1

  • SSM Health Davis Duehr Dean Eye Care - Whitewater Doing business as

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1063458354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 N TRATT ST",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901205",
            "telephone_number": "262-473-4514",
            "fax_number": "262-473-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 N TRATT ST",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901205",
            "telephone_number": "262-473-4514",
            "fax_number": "262-473-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "GRINNELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT - FINANCE",
        "authorized_official_telephone_number": "608-260-3586"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053358846",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Davis Duehr Dean Eye Care - Whitewater",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health Davis Duehr Dean Eye Care - Whitewater",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whitewater, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.