Reliv of Southern Wisconsin

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

RELIV OF SOUTHERN WISCONSIN

Practice address

201 Prairie View Dr
Beaver Dam, WI 53916-3406

Phone

(920) 356-0681

NPI assigned

Feb 9, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Vittorio Giuseppe Spadaro Sr.

Title

Chairman VP Nutrition

Phone

(920) 356-0681

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1629217062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S CLARK ST",
            "city": "MAYVILLE",
            "state": "WI",
            "postal_code": "530501488",
            "telephone_number": "920-356-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PRAIRIE VIEW DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163406",
            "telephone_number": "920-356-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIV OF SOUTHERN WISCONSIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "SPADARO",
        "authorized_official_first_name": "VITTORIO",
        "authorized_official_middle_name": "GIUSEPPE",
        "authorized_official_title_or_position": "CHAIRMAN VP NUTRITION",
        "authorized_official_telephone_number": "920-356-0681",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake Carpenter Quinn, PA-C, MSPAS
• Dawn Michelle Rabiego, LPN
• Radiology Associates of Beaver Dam LTD
• Rehab Resources Inc
• Ashley Lynn Rehbaum
• Timothy J Rentmeester, MD
• Courtney Rae Retzlaff, M.S. CCC-SLP
• J Scott Rhule, MA, LCSW, CSAC, ICS
• Richard P. Jennings D.O. S. C.
• Joel Riehbrandt

• All providers in Beaver Dam, WI
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.