Aspirus Medical Group, Inc.
Organization Active NPI Clinic/Center · Land O Lakes, WI
NPI 1851478952 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1851478952
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ASPIRUS MEDICAL GROUP, INC.
- Practice address
- 4348 Highway B
Unit B
Land O Lakes, WI 54540 - Phone
- (715) 547-6118
- NPI assigned
- Nov 1, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ASPIRUS MEDICAL GROUP, INC.
Authorized official
- Name
- Lori Peck
- Title
- VP Revenue Cycle
- Phone
- (715) 847-2988
Corporate family (same tax ID) 23
Practitioners 1
-
Nicole K Rice, N.P.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000267 | WI | Part B Supplier - Clinic/Group Practice | 1052223625 |
Receives reassigned benefits from 484 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Aspirus Clinic Pharmacy
- Part of
- Aspirus Clinic Pharmacy
Locations
4236 Highway B
Land O Lakes, WI 54540
Phone (715) 547-6118
5409 Vern Holmes Dr
Stevens Point, WI 54482
Phone (715) 342-1015
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | WI | Yes |
Addresses
Primary practice location
4348 Highway B
Unit B
Land O Lakes, WI 54540
Mailing address
29980 Network PL
Chicago, IL 60673-1299
Phone (715) 847-2304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21264600 | Medicaid | WI |
Other names
- Aspirus Land O Lakes Clinic
- Aspirus Clinics, Inc.
Other providers in Land O Lakes, WI
- Ascension Sacred Heart - St Mary'S Hospitals, Inc.
- Laura Marie Goll
- Peter J Schindelholz, DDS SC
- Jeanne Plunkett
- William E Raduege
- Shirley Kay Thompson
All providers in Land O Lakes, WI · Clinic/Center in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.