Divine Savior Healthcare, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

DIVINE SAVIOR HEALTHCARE, INC.

Doing business as

Aspirus Pardeeville Clinic

Practice address

102 Gillette Street
Pardeeville, WI 53954

Phone

(608) 429-2185

Fax

(608) 429-3966

NPI assigned

Oct 25, 2017

Last updated

Aug 26, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

DIVINE SAVIOR HEALTHCARE, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Lori Peck

Title

VP Revenue Cycle

Phone

(715) 847-2988

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ASPIRUS PARDEEVILLE CLINIC Doing business as

Part of

Divine Savior Hospital

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1861904294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY ROAD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539010387",
            "telephone_number": "608-745-0560",
            "fax_number": "608-742-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GILLETTE STREET",
            "city": "PARDEEVILLE",
            "state": "WI",
            "postal_code": "53954",
            "telephone_number": "608-429-2185",
            "fax_number": "608-429-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE SAVIOR HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVINE SAVIOR HEALTHCARE, INC.",
        "enumeration_date": "2017-10-25",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "715-847-2988",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32850500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASPIRUS PARDEEVILLE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brianna Nicole Bernett
• Kenneth Binkley, DDS
• Veve Cobbs, MIDWIFE CPM
• Morgan Anne Deakin, PHARMD
• Felicijan Chiropractic, Inc.
• Steven Felicijan, DC
• Marcie Heil
• Kate Hillyer, PHARMD
• Judith A Jolly, RN

• Rural Health Clinic/Center in Pardeeville, WI
• Providers in Pardeeville, WI by specialty
• Rural Health Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.