Active NPI
Valley Urologic Associates, SC
- Urology Physician
- Shawano, WI
National Provider Identifier
1699892240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- VALLEY UROLOGIC ASSOCIATES, SC
- Practice address
- 100 County Road B
Shawano, WI 54166 - Phone
- (920) 739-3537
- NPI assigned
- Mar 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert E Vlach Jr., MD
- Title
- President
- Phone
- (920) 739-3537
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
100 County Road B
Shawano, WI 54166
Mailing address
820 E Grant St
Appleton, WI 54911-3483
Phone (920) 739-3537
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 989963 | Other | WI | UNITED HEALTHCARE |
| 32748300 | Medicaid | WI |
National Provider Directory
National Provider Directory- Tax ID family
- Valley Urologic Associates SC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urology Physician
- Waupaca, WI
- NPI 1689791899
-
- Urology Physician
- Shawano, WI
- NPI 1275650269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1699892240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 E GRANT ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549113483",
"telephone_number": "920-739-3537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 COUNTY ROAD B",
"city": "SHAWANO",
"state": "WI",
"postal_code": "54166",
"telephone_number": "920-739-3537"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VALLEY UROLOGIC ASSOCIATES, SC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-26",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VLACH",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "920-739-3537",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "989963",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32748300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shawano, 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.