Organization Active NPI

Neurotech, LLC

  • Physiological Laboratory
  • Toledo, OH
National Provider Identifier
1265903710
Registry record updated Mar 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
NEUROTECH, LLC
Practice address
2255 W Laskey Rd Ste a-2
Toledo, OH 43613-3573
Phone
(262) 875-6620
Fax
(262) 754-0897
NPI assigned
Dec 10, 2018
Last updated
Mar 9, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NEUROTECH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2019

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

Authorized official

Name
Kristine Lisa Wildner
Title
Director of Contracting and Researc
Phone
(262) 875-6572

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EEG TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 2472E0500X
Sleep Disorder Diagnostic Clinic/Center 261QS1200X
Physiological Laboratory 293D00000X Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

2255 W Laskey Rd Ste a-2
Toledo, OH 43613-3573

Mailing address

626 W Moreland Blvd
Waukesha, WI 53188-2433
Phone (262) 875-6572

Other names 1

  • Neurotech Toledo Other name

National Provider Directory

National Provider Directory
Part of
Neurotech LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552089600000",
    "number": "1265903710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433",
            "telephone_number": "262-875-6572",
            "fax_number": "262-754-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 W LASKEY RD STE A-2",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436133573",
            "telephone_number": "262-875-6620",
            "fax_number": "262-754-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTECH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEUROTECH, LLC",
        "enumeration_date": "2018-12-10",
        "last_updated": "2019-03-09",
        "status": "A",
        "authorized_official_last_name": "WILDNER",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING AND RESEARC",
        "authorized_official_telephone_number": "262-875-6572"
    },
    "taxonomies": [
        {
            "code": "2472E0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Other, EEG",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurotech Toledo",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Neurotech Toledo",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2019; 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.