NPIMap

Organization Active NPI

Fox Valley Mental Health, L.L.C.

  • Psychiatry Physician
  • Oshkosh, WI
National Provider Identifier
1639211469
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
43051-020 Issued in WI
Legal business name
FOX VALLEY MENTAL HEALTH, L.L.C.
Practice address
2924 Scenic Dr
Oshkosh, WI 54904-7641
Phone
(920) 203-5742
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Maria Luisa Baldomero-Concepcion, M.D.
Title
Psychiatrist
Phone
(920) 203-5742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 43051-020 WI Primary

Addresses

Primary practice location

2924 Scenic Dr
Oshkosh, WI 54904-7641

Mailing address

2924 Scenic Dr
Oshkosh, WI 54904-7641
Phone (920) 203-5742

Other identifiers 1

IdentifierTypeStateIssuer
1639239486OtherWINPI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639211469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 SCENIC DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047641",
            "telephone_number": "920-203-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 SCENIC DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047641",
            "telephone_number": "920-203-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY MENTAL HEALTH, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALDOMERO-CONCEPCION",
        "authorized_official_first_name": "MARIA LUISA",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "920-203-5742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "43051-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639239486",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • 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.