Human Services Board Serving North Central Heatlh Care

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

1681 Issued in WI

Legal business name

HUMAN SERVICES BOARD SERVING NORTH CENTRAL HEATLH CARE

Practice address

213 W Wisconsin Ave
Tomahawk, WI 54487-1238

Phone

(715) 453-5381

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Michael Loy

Title

Interim Ceo

Phone

(715) 848-4600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Central Health Care Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Human Services Board Serving North Central Health Care

  • Multi-Specialty Clinic/Center
  • Merrill, WI
  • NPI 1528173689

  O20040813001207

  Same enrollment
• Human Services Board Serving North Central Health Care Facility

  • Multi-Specialty Clinic/Center
  • Wausau, WI
  • NPI 1205944543

  O20040813001207

  Same enrollment
• Human Services Board Serving North Central Heatlh Care

  • Multi-Specialty Clinic/Center
  • Antigo, WI
  • NPI 1134234206

  O20040813001207

  Same enrollment
• Human Services Board Serving North Central Heatlh Care Facility

  • Multi-Specialty Clinic/Center
  • Wausau, WI
  • NPI 1821106162

  O20040813001207

  Same enrollment

Locations

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285749341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036785",
            "telephone_number": "715-848-4600",
            "fax_number": "715-845-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W WISCONSIN AVE",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544871238",
            "telephone_number": "715-453-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SERVICES BOARD SERVING NORTH CENTRAL HEATLH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LOY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "715-848-4600"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WI",
            "license": "1681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42172800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Central Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Henkel, DPT
• Robert Hofschulte, DPT
• Wendy Anne Hoover, FNLP
• Mia Hoveland, DPT
• Whitney Marie Hribar, PT, DPT
• Dean R Hussong, DDS
• Joshua Drew Ice, LAT
• Victor Ierulli, MD
• Robert David Imm, DDS
• Amy Marie Imme

• Multi-Specialty Clinic/Center in Tomahawk, WI
• Providers in Tomahawk, WI by specialty
• Multi-Specialty Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.