Impacthealth, LLC

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

10158-30 Issued in WI

Legal business name

IMPACTHEALTH, LLC

Practice address

3219 N 51St Blvd
Milwaukee, WI 53216-3235

Phone

(414) 771-0543

Fax

(262) 649-4375

NPI assigned

Jun 13, 2013

Last updated

Jan 14, 2021By 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

Mrs. Yvette Johnson, APRN

Title

President

Phone

(414) 771-0543

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Yvette Johnson Other name

Tax ID family

Impacthealth2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Impacthealth

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Milwaukee, WI
  • NPI 1952709206
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yvette Johnson Towers, RN

  • Registered Nurse
  • Milwaukee, WI
  • NPI 1073805255
  NPD

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1104264001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3219 N 51ST BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163235",
            "telephone_number": "414-771-0543",
            "fax_number": "262-649-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3219 N 51ST BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163235",
            "telephone_number": "414-771-0543",
            "fax_number": "262-649-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACTHEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-771-0543",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "WI",
            "license": "10158-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073805255",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yvette Johnson",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Impact Physician Group, Wisconsin LLC
• Impacthealth
• Gabriella Imrei, RPH
• In and Out Transportation LLC
• In Dreams Hands Supportive and Personal Care Services Inc.
• In Due Time LLC
• In Good Hands Transportation

• Community Health Registered Nurse in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Community Health Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.