NPIMap

Organization Active NPI

Tellurian, Inc.

  • Community/Behavioral Health Agency
  • Baraboo, WI
National Provider Identifier
1104279330
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
3127 Issued in WI
Legal business name
TELLURIAN, INC.
Practice address
414 Broadway St
Suite 101
Baraboo, WI 53913-2488
Phone
(608) 402-4312
Fax
(608) 355-0459
NPI assigned
Jul 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Authorized official

Name
Mr. Kevin Florek
Title
Ceo
Phone
(608) 663-2120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 3127 WI Primary

Addresses

Primary practice location

414 Broadway St
Suite 101
Baraboo, WI 53913-2488

Mailing address

414 Broadway St
Suite 101
Baraboo, WI 53913-2488
Phone (608) 402-4312

Other names 1

  • Tellurian UCAN, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Tellurian Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1104279330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 BROADWAY ST",
            "address_2": "SUITE 101",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132488",
            "telephone_number": "608-402-4312",
            "fax_number": "608-355-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 BROADWAY ST",
            "address_2": "SUITE 101",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132488",
            "telephone_number": "608-402-4312",
            "fax_number": "608-355-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELLURIAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "FLOREK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "608-663-2120",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "3127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tellurian UCAN, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Baraboo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.