Interim Healthcare of Madison, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

206 Issued in WI

Legal business name

INTERIM HEALTHCARE OF MADISON, INC

Practice address

702 N Blackhawk Ave
Suite 215
Madison, WI 53705-3357

Phone

(608) 238-0268

Fax

(608) 238-7308

NPI assigned

Dec 13, 2006

Last updated

Mar 23, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David E Utter, RN, MS

Title

Administrator

Phone

(608) 238-0268

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1588725535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N BLACKHAWK AVE",
            "address_2": "SUITE 215",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053357",
            "telephone_number": "608-238-0268",
            "fax_number": "608-238-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N BLACKHAWK AVE",
            "address_2": "SUITE 215",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053357",
            "telephone_number": "608-238-0268",
            "fax_number": "608-238-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF MADISON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "UTTER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "608-238-0268",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, MS"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43103700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI HHA LICENSE NUMBER",
            "identifier": "206",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.