Minocqua J1

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

MINOCQUA J1

Practice address

7450 Titus Dr
Minocqua, WI 54548-9139

Phone

(715) 356-5206

Fax

(715) 358-2649

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Jim Ellis

Title

District Administrator

Phone

(715) 356-5206

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Alyssa Williams, OTR

  • Occupational Therapist
  • Minocqua, WI
  • NPI 1396439584
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1184803710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 TITUS DR",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489139",
            "telephone_number": "715-356-5206",
            "fax_number": "715-358-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 TITUS DR",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489139",
            "telephone_number": "715-356-5206",
            "fax_number": "715-358-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINOCQUA J1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "DISTRICT ADMINISTRATOR",
        "authorized_official_telephone_number": "715-356-5206"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44225800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William F Melms, MD
• Michael V. Cirilli D.C. Inc. (Cirilli Chiropractic)
• Charles R Michels, LCSW
• Theresa Kolb Miller
• Minocqua Health and Rehab LLC
• Susan Mitchler, PA
• Sean M Moe, PA-C
• Michael J Monson, MD
• Jolanta B. Mroz, MD
• Colleen Ann Mueller, APNP

• Local Education Agency (LEA) in Minocqua, WI
• Providers in Minocqua, WI by specialty
• Local Education Agency (LEA) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.