NPIMap

Organization Active NPI

SSM Health Care of Wisconsin Inc

  • Clinical Medical Laboratory
  • Janesville, WI
National Provider Identifier
1285020552
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
318 Issued in WI
Legal business name
SSM HEALTH CARE OF WISCONSIN INC
Practice address
3400 E Racine St
Janesville, WI 53546-2344
Phone
(608) 373-8000
Fax
(608) 314-8878
NPI assigned
Apr 13, 2015
Organization subpart
Yes
Parent organization
SSM HEALTH ST MARYS HOSPITAL - JANESVILLEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Joseph Minerath
Title
System Dir of Gov Reimbursement
Phone
(608) 258-6891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 318 WI Primary

Addresses

Primary practice location

3400 E Racine St
Janesville, WI 53546-2344

Mailing address

3400 E Racine St
Janesville, WI 53546-2344
Phone (608) 373-8000

Other names 1

  • REFERENCE LAB Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

National Provider Directory

National Provider Directory
Tax ID family
SSM Healthcare of Wisconsin Inc22 organizations share this tax ID, including this one
Part of
SSM Healthcare of Wisconsin Inc

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1285020552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462344",
            "telephone_number": "608-373-8000",
            "fax_number": "608-314-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462344",
            "telephone_number": "608-373-8000",
            "fax_number": "608-314-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF WISCONSIN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH ST MARYS HOSPITAL - JANESVILLE",
        "enumeration_date": "2015-04-13",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "MINERATH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "SYSTEM DIR OF GOV REIMBURSEMENT",
        "authorized_official_telephone_number": "608-258-6891"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "REFERENCE LAB",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "REFERENCE LAB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.