NPIMap

Organization Active NPI

Family Services of Northeast Wisconsin, Inc.

  • Case Management Agency
  • Appleton, WI
National Provider Identifier
1649397654
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
2561 Issued in WI
Legal business name
FAMILY SERVICES OF NORTHEAST WISCONSIN, INC.
Practice address
1500 W Rogers Ave
Appleton, WI 54914-5007
Phone
(920) 954-6804
Fax
(920) 954-6806
NPI assigned
Mar 23, 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
Thomas Martin
Title
President-Ceo
Phone
(920) 436-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 2561 WI Primary

Addresses

Primary practice location

1500 W Rogers Ave
Appleton, WI 54914-5007

Mailing address

300 Crooks St
Green Bay, WI 54301-4527
Phone (920) 436-6800

Other identifiers 1

IdentifierTypeStateIssuer
43008200MedicaidWI

Other names 1

  • Family Services - Fox Valley Day Treatment Other name

National Provider Directory

National Provider Directory
Tax ID family
Family SVCS of NE Wisco10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1500 W Rogers Ave
Appleton, WI 54914
Phone (920) 954-6804

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649397654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CROOKS ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014527",
            "telephone_number": "920-436-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W ROGERS AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145007",
            "telephone_number": "920-954-6804",
            "fax_number": "920-954-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICES OF NORTHEAST WISCONSIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT-CEO",
        "authorized_official_telephone_number": "920-436-6800"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WI",
            "license": "2561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43008200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Services - Fox Valley Day Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 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.