St. Croix Valley Surgical Associates

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

38459 Issued in WI

Legal business name

ST. CROIX VALLEY SURGICAL ASSOCIATES

Practice address

204 3Rd Avenue
Osceola, WI 54020-0597

Phone

(715) 294-4898

NPI assigned

Sep 28, 2006

Last updated

Aug 22, 2020By 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

Jessica Larson

Title

Office Manager

Phone

(715) 294-4898

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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.

• Anders E Ulland, M.D.

  • Surgery Physician
  • Amery, WI
  • NPI 1376620351
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619069630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 3RD AVENUE",
            "address_2": "PO BOX 597",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540200597",
            "telephone_number": "715-294-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 3RD AVENUE",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540200597",
            "telephone_number": "715-294-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX VALLEY SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "715-294-4898"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": "38459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32892400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN LICENSE",
            "identifier": "38459",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA LICENSE",
            "identifier": "36163",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erik A Severson, MD
• Shoreview Family Dental PLLC
• Nicole Rae Smith, M.D.
• Rebecca Smith
• St. Croix Orthopaedics, P.a.
• Jessie Lynn Stolp, APRN CNP
• Rachel Struemke, OTR/L
• Nicole D Svihel, PA-C
• Erin O'Connell Swanson, RDN, LDN
• Amanda Nicole Tembreull, M.D.

• Surgery Physician in Osceola, WI
• Providers in Osceola, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.