Andromeda Wellness Center Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ANDROMEDA WELLNESS CENTER INC

Practice address

582 Fargo TRL
Middleton, WI 53562-5667

Phone

(608) 216-4374

Fax

(608) 716-3148

NPI assigned

May 19, 2021

Last updated

May 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nura Misty Budzinski

Title

Owner

Phone

(608) 216-4374

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Misty Budzinski, LCSW

  • Clinical Social Worker
  • Middleton, WI
  • NPI 1851865018
  Medicare reassignment
• Lacey Kimpel, LCSW

  • Clinical Social Worker
  • Waukesha, WI
  • NPI 1285010009
  Medicare reassignment

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1144894494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6907 UNIVERSITY AVE STE 304",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535622767",
            "telephone_number": "608-216-4374",
            "fax_number": "608-716-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 FARGO TRL",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625667",
            "telephone_number": "608-216-4374",
            "fax_number": "608-716-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDROMEDA WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "BUDZINSKI",
        "authorized_official_first_name": "NURA",
        "authorized_official_middle_name": "MISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-216-4374"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amg Medical Services LLC (Ellie Mental Health)
• Cynthia Anderson-Keene, PHD
• Anna Freiburger Anderson
• Dorothy Mae Anderson
• Laura Anderson, APNP
• Jennifer Aney, MS
• Teresa Applebee
• Applewhite Dental Wisconsin, P.C. (Foxridge Dental)
• Alexandra Giselle Argento-Berrio, MD
• Taylor Jan Arndorfer, LMFT

• Clinical Social Worker in Middleton, WI
• Providers in Middleton, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.