Neurotech, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

NEUROTECH, LLC

Practice address

117 NE Trilein Dr Ste 202
Ankeny, IA 50021-2082

Phone

(262) 875-6626

Fax

(262) 754-0897

NPI assigned

Apr 17, 2019

Last updated

Apr 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristine Lisa Wildner

Title

Director of Contracting & Researc

Phone

(262) 875-6572

Specialties & licenses 3

Addresses

Other names 1

• Neurotech Nebraska Other name

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1912560772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433",
            "telephone_number": "262-875-6572",
            "fax_number": "262-754-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 NE TRILEIN DR STE 202",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500212082",
            "telephone_number": "262-875-6626",
            "fax_number": "262-754-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "WILDNER",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING & RESEARC",
        "authorized_official_telephone_number": "262-875-6572"
    },
    "taxonomies": [
        {
            "code": "246ZE0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurotech Nebraska",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Matthew Michael Ness, MHC, MFT
• Elisabeth Netjes, LMFT
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• Neurotech, LLC
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• Paula Neutzling, PTA
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• New Life Chiropractic
• New Life Counseling PC

• Physiological Laboratory in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Physiological Laboratory in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.