Ihc-Beaver Dam Anesthesia and Pain Management Services LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

IHC-BEAVER DAM ANESTHESIA AND PAIN MANAGEMENT SERVICES LLC

Practice address

707 S University Ave
Beaver Dam, WI 53916-3027

Phone

(414) 290-6720

Fax

(414) 290-6755

NPI assigned

Feb 13, 2009

Organization subpart

No

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

Authorized official

Name

Karen Vaughn

Title

Officer

Phone

(954) 838-2371

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1265671259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744489",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744489",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163027",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC-BEAVER DAM ANESTHESIA AND PAIN MANAGEMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-13",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "954-838-2371"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Marie Hulbert, LCSW
• Zachery Huybrecht, DDS
• Thomas W Hyke, PT
• Ellen Igl
• Ihc Beaver Dam Emergency Physicians, LLC
• Individual Care Services LLC
• Individualized Care Services
• Yuliana Iniguez, MS, LPC-IT
• Integrity Urologic, SC
• Carley Ann Jahnke, APNP

• Anesthesiology Physician in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Anesthesiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.