Impacthealth

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

101528-30 Issued in WI

Legal business name

IMPACTHEALTH

Practice address

3219 N 51St Blvd
Milwaukee, WI 53216-3235

Phone

(414) 771-0543

NPI assigned

Dec 18, 2014

Last updated

Dec 18, 2014By 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

Mrs. Yvette Johnson-Towers, MSN, APRNNPI 1073805255

Title

Directot

Phone

(414) 771-0453

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Impacthealth2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Impacthealth, LLC

  • Community Health Registered Nurse
  • Milwaukee, WI
  • NPI 1104264001
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yvette Johnson Towers, RN

  • Registered Nurse
  • Milwaukee, WI
  • NPI 1073805255
  NPD Authorized official

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1952709206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3219 N 51ST BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163235",
            "telephone_number": "414-771-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3219 N 51ST BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163235",
            "telephone_number": "414-771-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACTHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-TOWERS",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "DIRECTOT",
        "authorized_official_telephone_number": "414-771-0453",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN, APRN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WI",
            "license": "101528-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073805255",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104264001",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Immaculate Transportation LLC
• Immaculate Transportation LLC
• Grace Rothstein Immel, PA-C
• Impact Alcohol & Other Drug Abuse Services, Inc.
• Impact Physician Group, Wisconsin LLC
• Impacthealth, LLC
• Gabriella Imrei, RPH
• In and Out Transportation LLC
• In Dreams Hands Supportive and Personal Care Services Inc.
• In Due Time LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.