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General NPI Number Information
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NPI Number | 1730804477
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Entity Type | Organization
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Legal Business Name | MONOGRAM HEALTH PROFESSIONAL SERVICES OF WISCONSIN SC
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 2810 CROSSROADS DR STE 4000
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City | MADISON
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State | WI
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Zip | 53718-8014
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Country | US
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Telephone | 615-673-4455
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Fax | 615-432-4651
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Provider Business Mailing Address
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Address Line | 5410 MARYLAND WAY STE 400
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City | BRENTWOOD
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State | TN
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Zip | 37027-8087
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Country | US
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Telephone | 615-465-8684
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Fax | 629-240-6003
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Authorized Official
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Title or Position | GENERAL COUNSEL & SECRETARY
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Name | SHAWN L VERNER
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Credential |
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Telephone | 615-994-1889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1835C0206X
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Taxonomy Name | Cardiology Pharmacist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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