Pain Centers of Wisconsin - Sauk Prairie, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PAIN CENTERS OF WISCONSIN - SAUK PRAIRIE, LLC

Practice address

250 26TH St Ste 1140
Prairie Du Sac, WI 53578-2204

Phone

(414) 325-7246

Fax

(414) 325-3770

NPI assigned

Apr 22, 2019

Last updated

Apr 22, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

APM WISCONSIN MSO, LLCAs reported in NPPES

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

Authorized official

Name

Robert J Bunker

Title

Authorized Representative

Phone

(414) 325-3744

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1346803632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212059",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 26TH ST STE 1140",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782204",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CENTERS OF WISCONSIN - SAUK PRAIRIE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APM WISCONSIN MSO, LLC",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "BUNKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "414-325-3744"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly L Olson, APNP
• Laura Opie, RDH
• Michael John Orrico, PH.D.
• Orthopedic Associates of Sauk Prairie S.C.
• Andrew Benton Padley, APNP
• Pain Centers of Wisconsin - Sauk Prairie, LLC
• Theodore Sheldon Parins, M.D.
• Pathway to Wellness Community Clinic SC
• Andrea D Paul, R.D.H.
• Linda M Peeples, R.D.H.

• Durable Medical Equipment & Medical Supplies in Prairie Du Sac, WI
• Providers in Prairie Du Sac, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.