Organization Active NPI

Vintage View Farm Inc

Doing business as Vintage View Therapy

  • Preferred Provider Organization
  • Mequon, WI
National Provider Identifier
1841694650
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
VINTAGE VIEW FARM INC
Doing business as
Vintage View Therapy
Practice address
7230 W Highland Rd
Mequon, WI 53092-1002
Phone
(262) 242-1110
Fax
(262) 236-9589
NPI assigned
Oct 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Authorized official

Name
Adam Wallow
Title
Managing Principal
Phone
(262) 242-1110

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X
Preferred Provider Organization 305R00000X WI Primary

Addresses

Primary practice location

7230 W Highland Rd
Mequon, WI 53092-1002

Mailing address

7230 W Highland Rd
Mequon, WI 53092-1002
Phone (262) 242-1110

Other identifiers 1

IdentifierTypeStateIssuer
0100OtherWINA

Other names 1

  • Vintage View Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

7230 W Highland Rd
Thiensville, WI 53092
Phone (262) 242-1110

Practitioners & affiliated clinicians

Practitioners 4

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": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1841694650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7230 W HIGHLAND RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921002",
            "telephone_number": "262-242-1110",
            "fax_number": "262-236-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7230 W HIGHLAND RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921002",
            "telephone_number": "262-242-1110",
            "fax_number": "262-236-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE VIEW FARM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "WALLOW",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "MANAGING PRINCIPAL",
        "authorized_official_telephone_number": "262-242-1110"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "0100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vintage View Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.