Integrative Health Center of Central Wisconsin LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INTEGRATIVE HEALTH CENTER OF CENTRAL WISCONSIN LLC

Doing business as

Integrative Health Center of Central Wisconsin LLC

Practice address

3205 E Washington Ave Ste a
Madison, WI 53704-4332

Phone

(608) 222-2700

Fax

(608) 222-2771

NPI assigned

Oct 25, 2019

Last updated

Jan 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Cotter, MD

Title

Owner

Phone

(608) 222-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Integrative Health Center of Central Wisconsin LLC Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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.

• Aaron J Henkel, ND

  • Naturopath
  • Deerfield, WI
  • NPI 1134279003
  NPD (past)

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1255974952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 E WASHINGTON AVE STE A",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 E WASHINGTON AVE STE A",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044332",
            "telephone_number": "608-222-2700",
            "fax_number": "608-222-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE HEALTH CENTER OF CENTRAL WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "COTTER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-222-2700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34668700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://familynaturalmedicine.com/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "3205 E Washington Ave Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537044332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Integrative Health Center of Central Wisconsin LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Integrative Health Center of Central Wisconsin LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Interpersonnel

• Family Medicine Physician in Madison, WI
• Providers in Madison, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.