Midstate Medical Express

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

MIDSTATE MEDICAL EXPRESS

Practice address

512 W Pleasant St
Portage, WI 53901-2012

Phone

(608) 742-8603

Fax

(608) 745-0640

NPI assigned

Feb 9, 2009

Last updated

Feb 9, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra L Watson

Title

Partner/Office Manager

Phone

(608) 742-8603

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1669611083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 303",
            "address_2": "512 W PLEASANT ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539010303",
            "telephone_number": "608-742-8603",
            "fax_number": "608-745-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 W PLEASANT ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539012012",
            "telephone_number": "608-742-8603",
            "fax_number": "608-745-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDSTATE MEDICAL EXPRESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER/OFFICE MANAGER",
        "authorized_official_telephone_number": "608-742-8603",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41453400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander B Mentzel, MS, LPC-IT
• Kendra Lynn Mercer, OTR
• Susan E. Mertely, RN
• Julie Kay Metzler
• MH Health Care Services, PC
• Cheryl Millard, LCSW
• Jocelyn R Miller, PHD
• Jennifer L Millholland, M.S.,CCC/SLP
• Vasilisa Mironovich, M.D.
• Daniel Joseph Moore, PHARMD

• Non-emergency Medical Transport (VAN) in Portage, WI
• Providers in Portage, WI by specialty
• Non-emergency Medical Transport (VAN) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.