NPIMap

Organization Active NPI

Sheboygan Comprehensive Treatment Center

  • Community/Behavioral Health Agency
  • Sheboygan, WI
National Provider Identifier
1447609029
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
16934-130 Issued in WI
Legal business name
SHEBOYGAN COMPREHENSIVE TREATMENT CENTER
Practice address
2842 S Business Dr
Sheboygan, WI 53081-6518
Phone
(920) 458-6527
NPI assigned
Jun 6, 2016
Last updated
Jun 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Authorized official

Name
Cary Tauchman, M.D.
Title
Medical Director
Phone
(920) 458-6527

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 16934-130 WI Primary

Addresses

Primary practice location

2842 S Business Dr
Sheboygan, WI 53081-6518

Mailing address

W1781 Puddlefort St
Mount Calvary, WI 53057-9714
Phone (920) 904-3533

Other identifiers 1

IdentifierTypeStateIssuer
101YA0400XMedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Professional Rec Net SC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2842 S Business Dr
Sheboygan, WI 53081
Phone (920) 264-0390

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1447609029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W1781 PUDDLEFORT ST",
            "city": "MOUNT CALVARY",
            "state": "WI",
            "postal_code": "530579714",
            "telephone_number": "920-904-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2842 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816518",
            "telephone_number": "920-458-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEBOYGAN COMPREHENSIVE TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "TAUCHMAN",
        "authorized_official_first_name": "CARY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "920-458-6527",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "16934-130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YA0400X",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.