MD21 Global

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MD21 GLOBAL

Doing business as

AvanceMD

Practice address

601 Genesee St Unit 303
Delafield, WI 53018-1410

Phone

(888) 498-5296

Fax

(888) 495-8194

NPI assigned

Sep 19, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Tara Dall, MDNPI 1649243445

Title

Medical Director

Phone

(888) 498-5296

Specialties & licenses 1

Addresses

Other names 1

• AvanceMD Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tara L. Dall, MD

  • Family Medicine Physician
  • Delafield, WI
  • NPI 1649243445
  NPD Authorized official

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1932821733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GENESEE ST UNIT 303",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181410",
            "telephone_number": "888-498-5296",
            "fax_number": "888-495-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GENESEE ST UNIT 303",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181410",
            "telephone_number": "888-498-5296",
            "fax_number": "888-495-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD21 GLOBAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-17",
        "status": "A",
        "authorized_official_last_name": "DALL",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "888-498-5296",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AvanceMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelly R Lund, LCSW
• Jamie L. Mandigo, DDS
• Many Roads Clinic
• Melissa D Marsh, PT
• Darcy Jo McCormick, PTA, CPT
• Sara Marie Mehring, RN
• Brittany Joelle Meyer, MD
• Jaclyn Piskule Meyers, LMT
• Louisa Miles
• Kinzie Millar, RD

• Clinic/Center in Delafield, WI
• Providers in Delafield, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.