Active NPI
Quad/Med, LLC
- Primary Care Clinic/Center
- Oconomowoc, WI
National Provider Identifier
1134033368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- QUAD/MED, LLC
- Practice address
- 888 Thackeray TRL Ste 103
Oconomowoc, WI 53066-4342 - Phone
- (414) 566-8100
- NPI assigned
- Oct 2, 2026
- Last updated
- Oct 2, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert L Poulsen Jr.
- Title
- Chief Financial Officer
- Phone
- (414) 566-8400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | NU | Primary |
Addresses
Primary practice location
888 Thackeray TRL Ste 103
Oconomowoc, WI 53066-4342
Mailing address
W227N6103 Sussex Rd
Sussex, WI 53089-3969
Phone (414) 566-8100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790899200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790899200000",
"number": "1134033368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W227N6103 SUSSEX RD",
"city": "SUSSEX",
"state": "WI",
"postal_code": "530893969",
"telephone_number": "414-566-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "888 THACKERAY TRL STE 103",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530664342",
"telephone_number": "414-566-8100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUAD/MED, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-02",
"last_updated": "2026-10-02",
"certification_date": "2026-10-02",
"status": "A",
"authorized_official_last_name": "POULSEN",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "414-566-8400",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oconomowoc, WI
- Prohealth Oconomowoc Memorial Hospital, Inc.
- Prohealth Oconomowoc Memorial Hospital, Inc. (ProHealth Pharmacy - Oconomowoc)
- Prohealth Oconomowoc Memorial Hospital, Inc.
- Beth Provost, LCSW, LMSW
- Purity Dialysis Centers, Inc (Oconomowoc Dialysis Center)
- Adam T. Quetsch, DDS
- Brian James Quick, LPC
- Radiology Consultants of Wisconsin
- Raina L. Hollenbaugh, M.D., S.C.
- Francis P Ramirez, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.