NPIMap

Organization Active NPI

Jefferson County CLTS Waiver

  • Case Management Agency
  • Jefferson, WI
National Provider Identifier
1861219081
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
JEFFERSON COUNTY CLTS WAIVER
Practice address
1541 Annex Rd
Jefferson, WI 53549-9803
Phone
(920) 674-3105
NPI assigned
Sep 20, 2024
Organization subpart
Yes
Parent organization
JEFFERSON COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Brian Bellford, CPA
Title
Deputy Director
Phone
(920) 674-3105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1541 Annex Rd
Jefferson, WI 53549-9803

Mailing address

1541 Annex Rd
Jefferson, WI 53549-9803
Phone (920) 674-3105

National Provider Directory

National Provider Directory
Tax ID family
Jefferson County Health Deparment12 organizations share this tax ID, including this one
Part of
Jefferson County Health Deparment

Other organizations with this tax ID 11

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": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1861219081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499803",
            "telephone_number": "920-674-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499803",
            "telephone_number": "920-674-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY CLTS WAIVER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEFFERSON COUNTY",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "BELLFORD",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "920-674-3105",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.