HEART AND VASCULAR INSTITUTE OF WISCONSIN – NPI #1053884478
Internal Medicine

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

HEART AND VASCULAR INSTITUTE OF WISCONSIN is a provider located in APPLETON, WI. NPPES has assigned the NPI number 1053884478 to HEART AND VASCULAR INSTITUTE OF WISCONSIN on January 08, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “HEART AND VASCULAR INSTITUTE OF WISCONSIN” is a dba name, the actual legal business name for this organization is HEART AND VASCULAR OF WISCONSIN, SC. The primary taxonomy selected by this provider is 207RC0000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Cardiovascular Disease

The NPI profile was previously updated about 4 years ago on Oct 24, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HEART AND VASCULAR INSTITUTE OF WISCONSIN below.

NPI Profile for
HEART AND VASCULAR OF WISCONSIN, SC

NPI Number
1053884478
Enumeration Date

(more than 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
HEART AND VASCULAR OF WISCONSIN, SC
Doing Business As (dba): HEART AND VASCULAR INSTITUTE OF WISCONSIN
Primary location
5045 W GRANDE MARKET DR
APPLETON, WI 54913-8517
Phone: (920) 886-9380 Fax: (920) 886-9381
Mailing address
PO BOX 610
GREEN BAY, WI 54305-0610
Phone: (920) 886-9380 Fax: (920) 886-9381
Organization Subpart
No
Authorized Official
LARRY SOBAL
CEO
Phone: (904) 574-6211
Updated
Certification Date
Oct 24, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for HEART AND VASCULAR INSTITUTE OF WISCONSIN

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidWI100088147
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RC0000X
- Internal Medicine / Cardiovascular Disease (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.