Organization Active NPI

SBH-Madison LLC

  • Psychiatry Physician
  • Middleton, WI
National Provider Identifier
1265189013
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SBH-MADISON LLC
Practice address
3169 Deming Way
Middleton, WI 53562-1435
Phone
(608) 716-8288
NPI assigned
Mar 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Paul Gilbert
Title
Chief Legal Officer
Phone
(615) 716-4924

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3169 Deming Way
Middleton, WI 53562-1435

Mailing address

3169 Deming Way
Middleton, WI 53562-1435
Phone (608) 690-6880

Other identifiers 1

IdentifierTypeStateIssuer
100192621MedicaidWI

Other names 1

  • Miramont Physician Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SBH-Madison LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

3169 Deming Way
Middleton, WI 53562
Phone (608) 716-8286

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1265189013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 DEMING WAY",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535621435",
            "telephone_number": "608-690-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 DEMING WAY",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535621435",
            "telephone_number": "608-716-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SBH-MADISON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "615-716-4924"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100192621",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miramont Physician Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Miramont Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.