NPIMap

Organization Active NPI

Northland Community Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westfield, WI
National Provider Identifier
1215075296
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NORTHLAND COMMUNITY SERVICES INC
Practice address
161 Spring St
Westfield, WI 53964
Phone
(608) 296-2139
Fax
(608) 296-1590
NPI assigned
Feb 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jon S Matthew, PHDNPI 1598899197
Title
Director
Phone
(608) 296-2139

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

161 Spring St
Westfield, WI 53964

Mailing address

PO Box 248
Westfield, WI 53964-0248
Phone (608) 296-2139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041202000301 WI Part B Supplier - Clinic/Group Practice 4981514387 Receives reassigned benefits from 4 practitioners
Practice locations: Adams, WI; Westfield, WI

National Provider Directory

National Provider Directory
Tax ID family
Northland Community Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

139 S Main St
Adams, WI 53910
Phone (608) 296-2139

161 Spring St
Westfield, WI 53964
Phone (608) 296-2139

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215075296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "WESTFIELD",
            "state": "WI",
            "postal_code": "539640248",
            "telephone_number": "608-296-2139",
            "fax_number": "608-296-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 SPRING ST",
            "city": "WESTFIELD",
            "state": "WI",
            "postal_code": "53964",
            "telephone_number": "608-296-2139",
            "fax_number": "608-296-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND COMMUNITY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTHEW",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "608-296-2139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.