Diane Cook

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Practice address

12489 State Highway 56
Viola, WI 54664-8914

Phone

(608) 538-3781

Fax

(608) 538-3782

NPI assigned

Feb 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mystic Acres, LLC

  • Assisted Living Facility
  • Viola, WI
  • NPI 1063370120
  NPD Authorized official
• Mystic Creek, LLC

  • Assisted Living Facility
  • Viola, WI
  • NPI 1356700025

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1093174765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17969 WILSON SPRINGS RD",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535818588",
            "telephone_number": "608-538-3781",
            "fax_number": "608-538-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12489 STATE HIGHWAY 56",
            "city": "VIOLA",
            "state": "WI",
            "postal_code": "546648914",
            "telephone_number": "608-538-3781",
            "fax_number": "608-538-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Anne Broser, STUDENT
• Carol M Dinges, M.D.
• Matthew Wayne Hajzl, D.C.
• Patricia Karn Helgerson
• Kickapoo Area School District
• Kickapoo Valley Rescue Squad Inc

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Viola, WI
• Providers in Viola, WI by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.