NPIMap

Organization Active NPI

St. Marys Dean Ventures, Inc

  • Durable Medical Equipment & Medical Supplies
  • Columbus, WI
National Provider Identifier
1326324005
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
WI
Legal business name
ST. MARYS DEAN VENTURES, INC
Practice address
1511 Park Ave
Columbus, WI 53925-2401
Phone
(920) 623-3012
Fax
(920) 356-0719
NPI assigned
Oct 26, 2011
Organization subpart
Yes
Parent organization
ST. MARYS DEAN VENTURES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Authorized official

Name
Amy J Grinnell
Title
Chief Financial Office
Phone
(608) 626-0035

Specialties & licenses 1

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

Addresses

Primary practice location

1511 Park Ave
Columbus, WI 53925-2401

Mailing address

118 W Maple Ave
Beaver Dam, WI 53916-2104
Phone (920) 356-1000

Other identifiers 1

IdentifierTypeStateIssuer
32824600MedicaidWI

Other names 1

  • Dean Clinic Columbus Family & Sports Orthopedic Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Evansville Clinic4 organizations share this tax ID, including this one
Part of
Evansville Clinic

Other organizations with this tax ID 3

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": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1326324005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 W MAPLE AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162104",
            "telephone_number": "920-356-1000",
            "fax_number": "920-356-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539252401",
            "telephone_number": "920-623-3012",
            "fax_number": "920-356-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARYS DEAN VENTURES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARYS DEAN VENTURES, INC",
        "enumeration_date": "2011-10-26",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "GRINNELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICE",
        "authorized_official_telephone_number": "608-626-0035"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": "WI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32824600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dean Clinic Columbus Family & Sports Orthopedic Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dean Clinic Columbus Family & Sports Orthopedic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.