NPIMap

Organization Active NPI

Prevea Clinic, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Seymour, WI
National Provider Identifier
1326177999
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PREVEA CLINIC, INC.
Practice address
958 Foote St
Seymour, WI 54165-1044
Phone
(920) 496-4700
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Richard D Rolston, MD
Title
President & Ceo
Phone
(920) 496-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

958 Foote St
Seymour, WI 54165-1044

Mailing address

958 Foote St
Seymour, WI 54165-1044
Phone (920) 496-4700

Other names 1

  • Prevea Health - DME Seymour Health Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Prevea Clinic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1326177999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 FOOTE ST",
            "city": "SEYMOUR",
            "state": "WI",
            "postal_code": "541651044",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 FOOTE ST",
            "city": "SEYMOUR",
            "state": "WI",
            "postal_code": "541651044",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVEA CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "ROLSTON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "920-496-4700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prevea Health - DME Seymour Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seymour, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.