NPIMap

Organization Active NPI

Interra Health Inc.

Doing business as Breakbush Center for Health

  • Primary Care Clinic/Center
  • Westfield, WI
National Provider Identifier
1073067013
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
1417905035 Issued in WI
Legal business name
INTERRA HEALTH INC.
Doing business as
Breakbush Center for Health
Practice address
N4993 6TH Dr
Westfield, WI 53964-8200
Phone
(608) 296-2121
NPI assigned
Aug 8, 2016
Last updated
May 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Authorized official

Name
Michelle D Ruth
Title
Implementation & Training Coordinat
Phone
(414) 375-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 1417905035 WI Primary

Addresses

Primary practice location

N4993 6TH Dr
Westfield, WI 53964-8200

Mailing address

8919 W Heather Ave
Milwaukee, WI 53224-2417
Phone (414) 375-1600

Other names 1

  • Breakbush Center for Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Interra Health Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557187200000",
    "number": "1073067013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8919 W HEATHER AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532242417",
            "telephone_number": "414-375-1600",
            "fax_number": "414-375-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N4993 6TH DR",
            "city": "WESTFIELD",
            "state": "WI",
            "postal_code": "539648200",
            "telephone_number": "608-296-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERRA HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2019-05-07",
        "status": "A",
        "authorized_official_last_name": "RUTH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "IMPLEMENTATION & TRAINING COORDINAT",
        "authorized_official_telephone_number": "414-375-1600"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "1417905035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breakbush Center for Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.