Ian R Powell, M.D.

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

39133 Issued in WI

Practice address

34700 Valley Rd
Oconomowoc, WI 53066-4500

Phone

(262) 646-1391

Fax

(262) 646-1393

NPI assigned

Feb 2, 2006

Last updated

Oct 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Addiction Medicine

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rosecrance IncGroup PAC ID 3779656582, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rosecrance Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1013289446
  Medicare reassignment Care Compare group NPD
• Rosecrance Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Champaign, IL
  • NPI 1265880694
  NPD
• Rosecrance Inc

  dba Rosecrance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moline, IL
  • NPI 1639892698
  NPD
• Connections Counseling, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Madison, WI
  • NPI 1497961551
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350691200000",
    "number": "1346212545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-1391",
            "fax_number": "262-646-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "IAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2012-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "39133",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "WI",
            "license": "39133",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "39133",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32580600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacie A Piacsek, DDS
• Lona Piber
• Mark S Polentini, MD
• Mischel Pomasl, CSW, CSAC
• Kaley Poole
• James Mitchell Powell, DC
• Prader Willi Homes of Oconomowoc LLC (Prader Willi Homes of Oconomowoc)
• Presbyterian Homes of Wisconsin, Inc. (Presbyterian Homes and Services Rehabilitation)
• Prescription Center Pharmacy
• Randy J Prestash, OD

• Addiction Medicine (Internal Medicine) Physician in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Addiction Medicine (Internal Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.