Innovation Alliance Ipa LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

INNOVATION ALLIANCE IPA LLC

Practice address

2105 E Enterprise Ave
Suite 101
Appleton, WI 54913-7862

Phone

(920) 560-1100

Fax

(920) 560-1112

NPI assigned

May 25, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Curt Kubiak

Title

Ceo

Phone

(920) 560-1001

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1831547397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 S GREEN BAY RD # 168",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563153",
            "telephone_number": "920-209-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE",
            "address_2": "SUITE 101",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137862",
            "telephone_number": "920-560-1100",
            "fax_number": "920-560-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION ALLIANCE IPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "KUBIAK",
        "authorized_official_first_name": "CURT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "920-560-1001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Illuminate Mental Health and Wellness Group
• Illuminate Mental Health LLC
• Innocent Onyebuchi Ilouno
• In-Home Care of Wisconsin, Inc.
• Industrial Therapy Solutions LLC
• Innovative Minds ABA of Wisconsin, LTD.
• Insight Behavioral Health
• Insight Behavioral Health Solutions, LLC
• Insight Eye Care, LLC
• Integrated Care and Cleaning Services

• Specialist in Appleton, WI
• Providers in Appleton, WI by specialty
• Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.