Organization Active NPI

Neurotech, LLC

  • Physiological Laboratory
  • Ankeny, IA
National Provider Identifier
1376002857
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
NEUROTECH, LLC
Practice address
117 NE Trilein Dr
Ankeny, IA 50021-2082
Phone
(262) 875-6626
Fax
(262) 754-0897
NPI assigned
Mar 14, 2019
Last updated
Nov 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Authorized official

Name
Kristine Lisa Wildner
Title
Director of Contracting & Research
Phone
(262) 875-6572

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X NU
Physiological Laboratory 293D00000X NU Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X NU
EEG Specialist/Technologist 246ZE0500X NU

Addresses

Primary practice location

117 NE Trilein Dr
Ankeny, IA 50021-2082

Mailing address

626 W Moreland Blvd
Waukesha, WI 53188-2433
Phone (262) 875-6572

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636675200000",
    "number": "1376002857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433",
            "telephone_number": "262-875-6572",
            "fax_number": "262-754-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 NE TRILEIN DR",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500212082",
            "telephone_number": "262-875-6626",
            "fax_number": "262-754-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-14",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A",
        "authorized_official_last_name": "WILDNER",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING & RESEARCH",
        "authorized_official_telephone_number": "262-875-6572"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "246ZE0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.