NPIMap

Organization Active NPI

St Mary's Dean Ventures Inc

Doing business as Breast Core Biopsy Center

  • Radiology Clinic/Center
  • Madison, WI
National Provider Identifier
1144392275
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
ST MARY'S DEAN VENTURES INC
Doing business as
Breast Core Biopsy Center
Practice address
1313 Fish Hatchery Road
Madison, WI 53715
Phone
(608) 252-7445
NPI assigned
Nov 14, 2006
Last updated
Oct 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Authorized official

Name
Amy J Grinnell
Title
Chief Financial Office
Phone
(608) 260-3586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1313 Fish Hatchery Road
Madison, WI 53715

Mailing address

PO Box 259317
1808 W Beltline Hwy
Madison, WI 53725-9317
Phone (608) 250-1316

Other identifiers 2

IdentifierTypeStateIssuer
543668OtherWIDEAN HEALTH PLAN
32837200MedicaidWI

Other names 1

  • Breast Core Biopsy Center Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1144392275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 259317",
            "address_2": "1808 W BELTLINE HWY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537259317",
            "telephone_number": "608-250-1316",
            "fax_number": "608-250-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 FISH HATCHERY ROAD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53715",
            "telephone_number": "608-252-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY'S DEAN VENTURES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "GRINNELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICE",
        "authorized_official_telephone_number": "608-260-3586"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "543668",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32837200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breast Core Biopsy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Breast Core Biopsy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.