Organization Active NPI

Twelvestone Infusion Centers LLC

  • Ophthalmology Physician
  • Appleton, WI
National Provider Identifier
1639091648
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TWELVESTONE INFUSION CENTERS LLC
Practice address
21 Park PL Ste a
Appleton, WI 54914-8872
Phone
(615) 278-3278
NPI assigned
Jul 29, 2026
Organization subpart
Yes
Parent organization
TWELVESTONE INFUSION CENTERS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Tara Harrelson
Title
Director
Phone
(615) 278-3278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

21 Park PL Ste a
Appleton, WI 54914-8872

Mailing address

PO Box 12369
Murfreesboro, TN 37129-0048

National Provider Directory

National Provider Directory

Locations

21 Park Pl
Ste A
Appleton, WI 54914

NPI Registry JSON

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1639091648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12369",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371290048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PARK PL STE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148872",
            "telephone_number": "615-278-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWELVESTONE INFUSION CENTERS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TWELVESTONE INFUSION CENTERS LLC",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "HARRELSON",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-278-3278"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.