NPIMap

Organization Active NPI

Diagnostic & Treatment Center, LLC

  • Clinical Medical Laboratory
  • Weston, WI
National Provider Identifier
1740294636
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
DIAGNOSTIC & TREATMENT CENTER, LLC
Practice address
3401 Cranberry Blvd
Weston, WI 54476
Phone
(715) 393-2489
Fax
(715) 241-9475
NPI assigned
Jul 28, 2006
Last updated
May 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Authorized official

Name
Colleen Chisnell
Title
Senior Director of Finance
Phone
(715) 393-2499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

3401 Cranberry Blvd
Weston, WI 54476

Mailing address

3401 Cranberry Blvd
Weston, WI 54476
Phone (715) 393-2489

Other identifiers 1

IdentifierTypeStateIssuer
32942200MedicaidWI

Other names 1

  • Diagnostic & Surgical Service Center, LLC Former legal business name

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1740294636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "54476",
            "telephone_number": "715-393-2489",
            "fax_number": "715-241-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "54476",
            "telephone_number": "715-393-2489",
            "fax_number": "715-241-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC & TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "CHISNELL",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "715-393-2499"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32942200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic & Surgical Service Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Weston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.