Chippewa Valley Technical College

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CHIPPEWA VALLEY TECHNICAL COLLEGE

Practice address

620 W Clairemont Ave
Hec 120
Eau Claire, WI 54701-6120

Phone

(715) 833-6271

Fax

(715) 833-6447

NPI assigned

Jan 19, 2007

Last updated

Apr 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Shelly Olson, MS

Title

Campus Administrator

Phone

(715) 833-6675

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366329600000",
    "number": "1093868358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W. CLARIEMONT AVE",
            "address_2": "HEC 120",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "715-833-6271",
            "fax_number": "715-833-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W CLAIREMONT AVE",
            "address_2": "HEC 120",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016120",
            "telephone_number": "715-833-6271",
            "fax_number": "715-833-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIPPEWA VALLEY TECHNICAL COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2013-04-19",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CAMPUS ADMINISTRATOR",
        "authorized_official_telephone_number": "715-833-6675",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BADGER CARE",
            "identifier": "38394300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chippewa Valley Medical Supply LLC
• Chippewa Valley Neuromonitoring, LLC
• Chippewa Valley Neurosciences LLC
• Chippewa Valley Optical LTD
• Chippewa Valley Speech Therapy LLC
• Chiro One Wellness Center of Eau Claire LLC
• Chirosource, LLC
• Catherine Choi, JD, DMD, MSD
• CHP-LTS, Inc.
• Ellen A Christensen, OT

• General Practice Dentistry in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.