NPIMap

Organization Active NPI

University of Wisconsin Hospitals and Clinics Authority

Doing business as UW Health Yahara Rehab Clinic

  • Durable Medical Equipment & Medical Supplies
  • Monona, WI
National Provider Identifier
1255827093
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Doing business as
UW Health Yahara Rehab Clinic
Practice address
1050 E Broadway
Monona, WI 53716-4023
Phone
(608) 222-8779
NPI assigned
Jul 5, 2018
Last updated
Jul 5, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Authorized official

Name
Robert Wayne Flannery
Title
Cfo
Phone
(608) 821-4223

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Prosthetic/Orthotic Supplier 335E00000X NU

Addresses

Primary practice location

1050 E Broadway
Monona, WI 53716-4023

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531
Phone (608) 829-5485

Other names 1

  • UW Health Yahara Rehab Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200203001618 WI DME Supplier - Medical Supply Company 4880503648 Practice locations: Monona, WI

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

National Provider Directory

National Provider Directory
Part of
University of Wisconsin Hospitals and Clinics Authority

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Uw Health Rehabilitation HospitalMadison, WI, CCN 523028 Hospital 5% Or Greater Direct Ownership Interest (40.6%) Jul 18, 2013
Uw Health Care DirectMiddleton, WI, CCN 527220 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jul 1, 2019

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1255827093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531",
            "telephone_number": "608-829-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E BROADWAY",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537164023",
            "telephone_number": "608-222-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY",
        "enumeration_date": "2018-07-05",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "FLANNERY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-821-4223"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UW Health Yahara Rehab Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UW Health Yahara Rehab Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.