Preventive Cardiology of Central Wisconsin LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22225020020 Issued in WI

Legal business name

PREVENTIVE CARDIOLOGY OF CENTRAL WISCONSIN LLC

Practice address

3910 Weston Ave
Weston, WI 54476

Phone

(715) 370-5433

Fax

(715) 359-3485

NPI assigned

Aug 4, 2006

Organization subpart

No

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

Authorized official

Name

Earl S Perrigo, MD

Title

President

Phone

(715) 370-5433

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1174531123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 2003",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544022003",
            "telephone_number": "715-370-5433",
            "fax_number": "715-359-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 WESTON AVE",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "54476",
            "telephone_number": "715-370-5433",
            "fax_number": "715-359-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE CARDIOLOGY OF CENTRAL WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PERRIGO",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-370-5433",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "22225020020",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "22225020020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34009800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Lyle Petersen, PHARMD
• Brittany Peterson
• Physiotherapy Associates Inc
• Jeffery A Poole, PAC
• Sally K Powell, OT
• Jodi J. Puent, M.D.
• Alycea Noel Pupp, APNP
• Tyler Qiu, MD
• Qwapee Consulting LLC
• James A Raczek, MD

• Internal Medicine Physician in Weston, WI
• Providers in Weston, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.