James Edward Subrod, SAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11645-130 Issued in WI

Practice address

201 N Pine St
Burlington, WI 53105-1935

Phone

(262) 767-0441

NPI assigned

Feb 2, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Agape Recovery Center, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Burlington, WI
  • NPI 1962620013
  NPD (past)

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1811269004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 W STATE ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051811",
            "telephone_number": "262-763-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N PINE ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051935",
            "telephone_number": "262-767-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBROD",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "SAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11645-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle D Storm, PA-C
• Anne C Strange, APNP
• Scott Street, PTA
• Jeannie Marie Stroh, MS, CCC-SLP
• Debra Jean Studey Leffelman, LM
• Amy E Swift-Johnson, M.D.
• Karen Swiggett
• Erin Marie Tauscher, M.S. OTR/L
• David L Taylor, MD
• Ted N Teberg, PT

• Addiction (Substance Use Disorder) Counselor in Burlington, WI
• Providers in Burlington, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.