Active NPI
County of Marquette
- Public Health or Welfare Agency
- Montello, WI
National Provider Identifier
1093734162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- Legal business name
- COUNTY OF MARQUETTE
- Practice address
- 480 Underwood Avenue
Montello, WI 53949-0181 - Phone
- (608) 297-3135
- Fax
- (608) 297-8923
- NPI assigned
- Jul 19, 2006
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Mrs. Suzanne McCartney
- Title
- Director Health Officer
- Phone
- (608) 297-9116
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100414000379 | WI | Part B Supplier - Mass Immunization (Roster Biller Only) | 6002942596 | Practice locations: Montello, WI |
National Provider Directory
National Provider Directory- Tax ID family
- County of Marquette
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- Montello, WI
- NPI 1306841317
-
- Community/Behavioral Health Agency
- Montello, WI
- NPI 1821479239
-
- Case Management Agency
- Montello, WI
- NPI 1013182757
-
- Early Intervention Provider Agency
- Montello, WI
- NPI 1780924696
Locations
77 W Park St
Montello, WI 53949
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
480 Underwood Avenue
Montello, WI 53949-0181
Mailing address
PO Box 129
77 West Park Street
Montello, WI 53949-0129
Phone (608) 297-3001
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41850900 | Medicaid | WI |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 13, 2009.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1250121600000",
"number": "1093734162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 129",
"address_2": "77 WEST PARK STREET",
"city": "MONTELLO",
"state": "WI",
"postal_code": "539490129",
"telephone_number": "608-297-3001",
"fax_number": "608-297-7606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 UNDERWOOD AVENUE",
"city": "MONTELLO",
"state": "WI",
"postal_code": "539490181",
"telephone_number": "608-297-3135",
"fax_number": "608-297-8923"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF MARQUETTE",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-19",
"last_updated": "2009-08-13",
"status": "A",
"authorized_official_last_name": "MCCARTNEY",
"authorized_official_first_name": "SUZANNE",
"authorized_official_title_or_position": "DIRECTOR HEALTH OFFICER",
"authorized_official_telephone_number": "608-297-9116",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41850900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Montello, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.