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NPI Code Detail

MEDICARE: SSM HEALTH CARE OF WISCONSIN INC

MEDICARE: SSM HEALTH CARE OF WISCONSIN INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1551896OTHERWIDEANCARE PROV #
2391023846OTHERWICOMMERCIAL INS PROV #
31009390OTHERWIPHYS PLUS PROV #
4391023846028OTHERWIBLUE CROSS PROV #
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336120401
Entity Type Code : Organization
Provider Name (Legal Business Name) : SSM HEALTH CARE OF WISCONSIN INC
Provider Business Mailing Address
First Line : 1802 W BELTLINE HWY
Second Line :
City : MADISON
State : WI
Zip : 53713-2334
Country : US
Telephone Number : 608-445-2411
Fax Number :
Provider Business Practice Location Address
First Line : 707 14TH ST
Second Line :
City : BARABOO
State : WI
Zip : 53913-1539
Country : US
Telephone Number : 608-356-1400
Fax Number :
Authorized Official
Title or Position : SYSTEM DIRECTOR - GOV'T REIMB.
Name : JOSEPH R MINERATH
Credential :
Telephone Number : 608-445-2411
Provider Enumeration Date : 11/07/2005
Last Update Date : 01/04/2023

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Directions to “SSM HEALTH CARE OF WISCONSIN INC ” Practice Location

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