Birch Boutique LLC

Primary specialty

Mastectomy FitterTaxonomy code 224900000X

Legal business name

BIRCH BOUTIQUE LLC

Practice address

612 Clemont St
Ste #8
Antigo, WI 54409-1988

Phone

(715) 350-7174

Fax

(715) 716-4330

NPI assigned

Sep 27, 2022

Organization subpart

No

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

Authorized official

Name

Greta Tomany, RN,CMFNPI 1740917541

Title

Owner

Phone

(715) 350-7174

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Greta M Tomany, RN, CMF

  • Mastectomy Fitter
  • Antigo, WI
  • NPI 1740917541
  NPD Authorized official

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1154045888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CLEMONT ST",
            "address_2": "STE #8",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544091988",
            "telephone_number": "715-350-7174",
            "fax_number": "715-716-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 CLEMONT ST",
            "address_2": "STE #8",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544091988",
            "telephone_number": "715-350-7174",
            "fax_number": "715-716-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRCH BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "TOMANY",
        "authorized_official_first_name": "GRETA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-350-7174",
        "authorized_official_credential": "RN,CMF"
    },
    "taxonomies": [
        {
            "code": "224900000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Mastectomy Fitter",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaina Below, FNP-BC
• Kathleen M Bender, R.D.
• Lauren K Bessa, MSW LCSW
• Karen Lynn Biedermann, PA
• Marc D Biedermann, M.D.
• Molly Marie Blemke, NP
• Anastacia Bostwick, LPN
• Jessica Marie Brandt, DPT
• Mary R Brayton, MS, OTR
• Stanley Ernest Brown, D.D.S.

• Mastectomy Fitter in Antigo, WI
• Providers in Antigo, WI by specialty
• Mastectomy Fitter in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.