NPIMap

Organization Active NPI

Grant Regional Family Practice

  • Family Medicine Physician
  • Lancaster, WI
National Provider Identifier
1750331807
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRANT REGIONAL FAMILY PRACTICE
Practice address
507 S Monroe St
Lancaster, WI 53813-2054
Phone
(608) 723-3293
Fax
(608) 723-3281
NPI assigned
May 11, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
GRANT REGIONAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Authorized official

Name
Nicole Clapp
Title
Ceo
Phone
(608) 723-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

507 S Monroe St
Lancaster, WI 53813-2054

Mailing address

507 S Monroe St
Lancaster, WI 53813-2054
Phone (608) 723-3293

Other identifiers 1

IdentifierTypeStateIssuer
32765000MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Potosi-Tennyson Med CL6 organizations share this tax ID, including this one
Part of
Potosi-Tennyson Med CL

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1750331807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S MONROE ST",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132054",
            "telephone_number": "608-723-3293",
            "fax_number": "608-723-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S MONROE ST",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132054",
            "telephone_number": "608-723-3293",
            "fax_number": "608-723-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT REGIONAL FAMILY PRACTICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRANT REGIONAL HEALTH CENTER",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "CLAPP",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "608-723-3200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32765000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.