NPIMap

Organization Active NPI

Community Care Resources Inc

  • Case Management Agency
  • Middleton, WI
National Provider Identifier
1669646584
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
1220 Issued in WI
Legal business name
COMMUNITY CARE RESOURCES INC
Practice address
6717 Stone Glen Drive
Middleton, WI 53562-3876
Phone
(608) 827-7100
Fax
(608) 827-7101
NPI assigned
Apr 22, 2008
Last updated
Apr 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Daniel J Simon, MSSWNPI 1174783823
Title
Executive Director
Phone
(608) 827-7100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 1220 WI Primary
Foster Care Agency 253J00000X 180017 WI

Addresses

Primary practice location

6717 Stone Glen Drive
Middleton, WI 53562-3876

Mailing address

6717 Stone Glen Drive
Middleton, WI 53562-3876
Phone (608) 827-7100

Other identifiers 1

IdentifierTypeStateIssuer
42179100MedicaidWI

National Provider Directory

National Provider Directory

Locations

6717 Stone Glen Dr
Middleton, WI 53562
Phone (608) 827-7100

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1669646584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6717 STONE GLEN DRIVE",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623876",
            "telephone_number": "608-827-7100",
            "fax_number": "608-827-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6717 STONE GLEN DRIVE",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623876",
            "telephone_number": "608-827-7100",
            "fax_number": "608-827-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE RESOURCES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "608-827-7100",
        "authorized_official_credential": "MSSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WI",
            "license": "1220",
            "primary": true
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "WI",
            "license": "180017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42179100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.