NPIMap

Organization Active NPI

Shawano County Department of Community Program

  • Community/Behavioral Health Agency
  • Shawano, WI
National Provider Identifier
1306003587
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2242 Issued in WI
Legal business name
SHAWANO COUNTY DEPARTMENT OF COMMUNITY PROGRAM
Practice address
504 Lakeland Rd
Shawano, WI 54166-3836
Phone
(715) 526-5547
Fax
(715) 526-5542
NPI assigned
May 16, 2008
Last updated
May 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Ms. Barbara Larson-Herber
Title
Executive Program Director
Phone
(715) 526-5547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 2242 WI Primary

Addresses

Primary practice location

504 Lakeland Rd
Shawano, WI 54166-3836

Mailing address

504 Lakeland Rd
Shawano, WI 54166-3836
Phone (715) 526-5547

Other identifiers 1

IdentifierTypeStateIssuer
43425800MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Shawano County Department of Community Program11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1306003587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 LAKELAND RD",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663836",
            "telephone_number": "715-526-5547",
            "fax_number": "715-526-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 LAKELAND RD",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663836",
            "telephone_number": "715-526-5547",
            "fax_number": "715-526-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWANO COUNTY DEPARTMENT OF COMMUNITY PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "LARSON-HERBER",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "EXECUTIVE PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "715-526-5547",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "2242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43425800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawano, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.