Interra Health Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

43771-20 Issued in WI

Legal business name

INTERRA HEALTH INC.

Doing business as

Three Waves InHealth Clinic and Wellness Center

Practice address

1675 N Barker Rd
Suite 200
Brookfield, WI 53045-5200

Phone

(414) 755-4898

NPI assigned

Sep 26, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Hansen, MD

Title

Chief Medical Officer

Phone

(414) 755-4898

Specialties & licenses 1

Addresses

Other names 1

• Three Waves InHealth Clinic and Wellness Center Doing business as

Locations

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1700335288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 OHIO ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549025825",
            "telephone_number": "920-267-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N BARKER RD",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455200",
            "telephone_number": "414-755-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERRA HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "414-755-4898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "43771-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Waves InHealth Clinic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Injury Rehabilitation Clinic II, Inc.
• Inner Bloom Therapy LLC
• Inner Resources Inc.
• Integrata LLC
• Integrative Family Wellness Center, LLC
• Ipack Pharmacy LLC (Ipack Pharmacy)
• Ivan Andrew Ireland, MD
• Iris Health Clinic LLC
• Brady Irwin, OTR
• Alyssa Isberner

• Primary Care Clinic/Center in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Primary Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.