NPIMap

Organization Active NPI

Dean Health Systems, Inc.

Doing business as SSM Health Dean Medical Group - Beaver Dam

  • Durable Medical Equipment & Medical Supplies
  • Beaver Dam, WI
National Provider Identifier
1073557013
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 Dean Medical Group - Beaver Dam
Practice address
705 S University Ave
Ste 500
Beaver Dam, WI 53916-3081
Phone
(920) 887-3102
Fax
(920) 885-8788
NPI assigned
Jun 16, 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

705 S University Ave
Ste 500
Beaver Dam, WI 53916-3081

Mailing address

705 S University Ave
Ste 500
Beaver Dam, WI 53916-3081
Phone (920) 887-3102

Other identifiers 1

IdentifierTypeStateIssuer
1053358846MedicaidWI

Other names 1

  • SSM Health Dean Medical Group - Beaver Dam Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dean Medical Center27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

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": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1073557013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE",
            "address_2": "STE 500",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163081",
            "telephone_number": "920-887-3102",
            "fax_number": "920-885-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE",
            "address_2": "STE 500",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163081",
            "telephone_number": "920-887-3102",
            "fax_number": "920-885-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "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 Dean Medical Group - Beaver Dam",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health Dean Medical Group - Beaver Dam",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaver Dam, 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.