NPIMap

Organization Active NPI

Caillier Clinic LTD

  • Clinical Neuropsychologist
  • Eau Claire, WI
National Provider Identifier
1659453058
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1119 Issued in WI
Legal business name
CAILLIER CLINIC LTD
Practice address
2620 Stein Blvd
Eau Claire, WI 54701-6201
Phone
(715) 836-0064
Fax
(715) 836-0065
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Authorized official

Name
Dr. Paul M Caillier, PH.D.NPI 1467534883
Title
Director
Phone
(715) 836-0064

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 1119 WI
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 1119 WI Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

2620 Stein Blvd
Eau Claire, WI 54701-6201

Mailing address

2620 Stein Blvd
Eau Claire, WI 54701-6201
Phone (715) 836-0064

Other identifiers 1

IdentifierTypeStateIssuer
42122900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050407001232 WI Part B Supplier - Clinic/Group Practice 7416904784 Receives reassigned benefits from 13 practitioners
Practice locations: Eau Claire, WI

National Provider Directory

National Provider Directory

Locations

475 Chippewa Mall Dr
Ste 315
Chippewa Falls, WI 54729

2620 Stein Blvd
Eau Claire, WI 54701
Phone (715) 831-0100

2620 Stein Blvd
Ste B
Eau Claire, WI 54701
Phone (715) 458-2575

2004 Highland Ave
Ste H
Eau Claire, WI 54701

1200 Hosford St
Ste 101
Hudson, WI 54016

700 Wolske Bay Rd
Ste 100
Menomonie, WI 54751

312 W Knapp St
Ste B
Rice Lake, WI 54868

Practitioners & affiliated clinicians

Practitioners 94

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

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1659453058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016201",
            "telephone_number": "715-836-0064",
            "fax_number": "715-836-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016201",
            "telephone_number": "715-836-0064",
            "fax_number": "715-836-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAILLIER CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "CAILLIER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-836-0064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1119",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "WI",
            "license": "1119",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42122900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.