Supporting Provider Services

Primary specialty

Child Physical Disabilities Respite CareTaxonomy code 385HR2065X

Legal business name

SUPPORTING PROVIDER SERVICES

Practice address

8330 S Wynona CT
Oak Creek, WI 53154-2740

Phone

(262) 527-1282

NPI assigned

Aug 19, 2015

Organization subpart

No

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

Authorized official

Name

Theresa Buford

Title

Vocational Rehabilitation

Phone

(262) 527-1282

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1114393527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8330 S WYNONA CT",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542740",
            "telephone_number": "262-527-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 S WYNONA CT",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542740",
            "telephone_number": "262-527-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTING PROVIDER SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "BUFORD",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "VOCATIONAL REHABILITATION",
        "authorized_official_telephone_number": "262-527-1282"
    },
    "taxonomies": [
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Ann Stouffer, MS-CCC-SLP
• Antoinette Marie Stout, MS, LPC
• Samantha Straley, BCBA
• Daniel Robert Strommen, RPH
• Ellen Stueckroth, MSW, LCSW
• Anthony Sustachek, PT
• Jennifer Dawn Svicek, PTA
• Symmetry Pain & Wellness Center LLC
• Jeff Taylor
• Veronica Tent, MD

• Respite Care in Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Respite Care in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.