MEDICARE: WISCONSIN VIRTUAL ACADEMIES

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
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1235931601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WISCONSIN VIRTUAL ACADEMIES

Provider Business Mailing Address
First Line	:	4721 DALE CURTIN DR
Second Line	:
City	:	MCFARLAND
State	:	WI
Zip	:	53558-8958
Country	:	US
Telephone Number	:	608-577-7550
Fax Number	:

Provider Business Practice Location Address
First Line	:	4721 DALE CURTIN DR
Second Line	:
City	:	MCFARLAND
State	:	WI
Zip	:	53558-8958
Country	:	US
Telephone Number	:	608-577-7550
Fax Number	:

Authorized Official
Title or Position	:	ACAD. ADMIN, SPECIAL PROGRAMS
Name	:	REBECCA EBERHARDT
Credential	:	MSED
Telephone Number	:	608-577-7550

Provider Enumeration Date	:	03/26/2025
Last Update Date	:	03/26/2025

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