Fox Valley Autism Treatment Program

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

152-140 Issued in WI

Legal business name

FOX VALLEY AUTISM TREATMENT PROGRAM

Practice address

W556 Wrightstown Rd
Kaukauna, WI 54130-9701

Phone

(920) 205-0475

NPI assigned

Feb 1, 2018

Organization subpart

No

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

Authorized official

Name

Staci FergNPI 1922451657

Title

President

Phone

(920) 205-0475

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Staci Ferg, BCBA

  • Behavior Analyst
  • Kaukauna, WI
  • NPI 1922451657
  NPD Authorized official

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1336648666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W556 WRIGHTSTOWN RD",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541309701",
            "telephone_number": "920-205-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W556 WRIGHTSTOWN RD",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541309701",
            "telephone_number": "920-205-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY AUTISM TREATMENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "FERG",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-205-0475"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "152-140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100059553",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William J. Farrow, D.D.S.
• Amy Fehlauer, PTA
• Staci Ferg, BCBA
• Robin M Fischer, LPC
• Beth M Fluette, RN
• Elliot B Franczek, MD
• Nicole Christine Giordana, M.S.
• Gerald E. Gomm, D.C.
• Matthew H Goodman, PHARMD
• Joseph C Graunke, MD

• Behavior Analyst in Kaukauna, WI
• Providers in Kaukauna, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.