NPIMap

Organization Active NPI

Interra Health Inc.

Doing business as Life Wellness Center - Neenah

  • Primary Care Clinic/Center
  • Neenah, WI
National Provider Identifier
1538652144
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
INTERRA HEALTH INC.
Doing business as
Life Wellness Center - Neenah
Practice address
7273 State Road 76
Neenah, WI 54956-9614
Phone
(920) 727-7599
Fax
(888) 892-0604
NPI assigned
Jun 8, 2018
Last updated
Feb 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Authorized official

Name
Michelle D Ruth
Title
Implementation & Training Coordinat
Phone
(262) 330-2827

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

7273 State Road 76
Neenah, WI 54956-9614

Mailing address

8919 W Heather Ave
Milwaukee, WI 53224-2417
Phone (414) 375-1623

Other names 1

  • Life Wellness Center - Neenah Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michelle.ruth@healics.com Other

National Provider Directory

National Provider Directory
Tax ID family
Interra Health Inc8 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

3003 Breezewood Ln
Neenah, WI 54956
Phone (920) 722-2491

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": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613001600000",
    "number": "1538652144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8919 W HEATHER AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532242417",
            "telephone_number": "414-375-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7273 STATE ROAD 76",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549569614",
            "telephone_number": "920-727-7599",
            "fax_number": "888-892-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERRA HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "RUTH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "IMPLEMENTATION & TRAINING COORDINAT",
        "authorized_official_telephone_number": "262-330-2827"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michelle.ruth@healics.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "michelle.ruth@healics.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "michelle.ruth@healics.com",
            "address_1": "8919 W Heather Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532242417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Wellness Center - Neenah",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Life Wellness Center - Neenah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.