Madison Neuropsychological Services LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

3198-57 Issued in WI

Legal business name

MADISON NEUROPSYCHOLOGICAL SERVICES LLC

Practice address

6510 Grand Teton PLZ Ste 102
Ste 24
Madison, WI 53719

Phone

(608) 841-1606

Fax

(608) 492-2573

NPI assigned

Feb 29, 2016

Last updated

Jun 21, 2018By 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

Dr. Sarah E Porter, PSYDNPI 1306247747

Title

Owner

Phone

(608) 841-1606

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 6

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.

• Teresa M Susmaras, PHD

  • Clinical Neuropsychologist
  • La Crosse, WI
  • NPI 1710357017
  Medicare reassignment NPD
• Sarah Emma Porter, PSYD

  • Clinical Psychologist
  • Madison, WI
  • NPI 1306247747
  Authorized official Same address or phone
• Katarina Marsh, PSYD

  • Clinical Psychologist
  • Madison, WI
  • NPI 1376396903
  NPD
• Amy M Connell, MD

  • Psychiatry Physician
  • Janesville, WI
  • NPI 1396781985
  NPD (past)
• Elliot R Lee, M.D.

  • Psychiatry Physician
  • Madison, WI
  • NPI 1669602439
  NPD (past)
• Lawrence J Mandt, PH.D.

  • Psychologist
  • Madison, WI
  • NPI 1255361002

  Clinical

  NPD (past)

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1982064366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLZ STE 102",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191031",
            "telephone_number": "608-841-1606",
            "fax_number": "608-492-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLZ STE 102",
            "address_2": "STE 24",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53719",
            "telephone_number": "608-841-1606",
            "fax_number": "608-492-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON NEUROPSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-841-1606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WI",
            "license": "3198-57",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3198-57",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Neuropsychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.