Organization Active NPI

Mineral Point Medical Center SC

  • Family Medicine Physician
  • Mineral Point, WI
National Provider Identifier
1104902766
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MINERAL POINT MEDICAL CENTER SC
Practice address
104 High St
Mineral Point, WI 53565-1289
Phone
(608) 987-2346
Fax
(608) 987-2644
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

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

Authorized official

Name
Ms. Chris M Slaney
Title
Credentialing Officer
Phone
(608) 987-2346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X WI Primary

Addresses

Primary practice location

104 High St
Mineral Point, WI 53565-1289

Mailing address

104 High St
Mineral Point, WI 53565-1289
Phone (608) 987-2346

Other identifiers 1

IdentifierTypeStateIssuer
43054800MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360281600000",
    "number": "1104902766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HIGH ST",
            "city": "MINERAL POINT",
            "state": "WI",
            "postal_code": "535651289",
            "telephone_number": "608-987-2346",
            "fax_number": "608-987-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HIGH ST",
            "city": "MINERAL POINT",
            "state": "WI",
            "postal_code": "535651289",
            "telephone_number": "608-987-2346",
            "fax_number": "608-987-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERAL POINT MEDICAL CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-02-08",
        "status": "A",
        "authorized_official_last_name": "SLANEY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING OFFICER",
        "authorized_official_telephone_number": "608-987-2346",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43054800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.