St. Marys Dean Ventures Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

ST. MARYS DEAN VENTURES INC.

Doing business as

DAVIS DUEHR DEAN BOSCOBEL

Practice address

310 Parker St
Boscobel, WI 53805-1633

Phone

(608) 375-6001

Fax

(608) 375-6011

NPI assigned

Jun 21, 2006

Organization subpart

Yes

Parent organization

ST. MARYS DEAN VENTURES INC.As reported in NPPES

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

Authorized official

Name

Amy J Grinnell

Title

Chief Financial Office

Phone

(608) 260-3586

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• DAVIS DUEHR DEAN BOSCOBEL Doing business as

Part of

Evansville Clinic

Member of 2

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

• Memorial Hospital of Boscobel

  • Rural Health Clinic/Center
  • Fennimore, WI
  • NPI 1437448891

  Member Of

  NPD member
• SSM Health Care of Wisconsin Inc

  • Certified Registered Nurse Anesthetist
  • Baraboo, WI
  • NPI 1336120401

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1093751653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051633",
            "telephone_number": "608-375-6001",
            "fax_number": "608-375-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051633",
            "telephone_number": "608-375-6001",
            "fax_number": "608-375-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARYS DEAN VENTURES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARYS DEAN VENTURES INC.",
        "enumeration_date": "2006-06-21",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "GRINNELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICE",
        "authorized_official_telephone_number": "608-260-3586"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL VISION ADMINISTR",
            "identifier": "22649",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "570986",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION INS PLAN OF AMERIC",
            "identifier": "054014",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "28845",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE OF WORKERS COMP",
            "identifier": "137082538",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38723700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DAVIS DUEHR DEAN BOSCOBEL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DAVIS DUEHR DEAN BOSCOBEL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tammy Shepherd
• Emily Marie Simon, CNM
• Kimberly Lynn Skinner, PT
• Jared Snyder
• Alison Spany, CPM
• Ashley Nicole Stanek, RCEP
• Maryann Stangl
• Nicole M Steldt, LCSW
• Jean M Straka, PTA
• Ameen Taleb, M.D.

• Eyewear Supplier in Boscobel, WI
• Providers in Boscobel, WI by specialty
• Eyewear Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.