Organization Active NPI

University Clinicians LLC

  • Health Service Clinic/Center
  • Appleton, WI
National Provider Identifier
1740859347
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
UNIVERSITY CLINICIANS LLC
Doing business as
University Clinicians Mini-Clinic
Practice address
133 E College Ave Ste C
Appleton, WI 54911-5710
Phone
(920) 470-7480
Fax
(920) 903-1452
NPI assigned
Jun 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Authorized official

Name
Jude P Jean-Pierre, RPHNPI 1821622309
Title
Ceo
Phone
(920) 470-7480

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084A0401X
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

133 E College Ave Ste C
Appleton, WI 54911-5710

Mailing address

133 E College Ave
Appleton, WI 54911-5710
Phone (920) 470-7480

Other names 1

  • University Clinicians Mini-Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

133 E College Ave
Appleton, WI 54911
Phone (920) 470-7480

133 E College Ave
Ste C
Appleton, WI 54911
Phone (920) 470-7480

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1740859347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115710",
            "telephone_number": "920-470-7480",
            "fax_number": "920-903-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E COLLEGE AVE STE C",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115710",
            "telephone_number": "920-470-7480",
            "fax_number": "920-903-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY CLINICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "JEAN-PIERRE",
        "authorized_official_first_name": "JUDE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "920-470-7480",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Clinicians Mini-Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.