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SBH-MADISON LLC NPI 1265189013


NPI Information

NPI: 1265189013
Provider Name: SBH-MADISON LLC

Doing Business As: MIRAMONT PHYSICIAN GROUP

Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

CLIA Number: 52D2225506

Address:
3169 DEMING WAY
MIDDLETON, WI
ZIP 53562
Phone: (608) 716-8288
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SBH-MADISON LLC is a psychiatry psychiatry neurology in Middleton, WI. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. SBH-MADISON LLC NPI is 1265189013. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Miramont Physician Group.

The provider's business location address is:

3169 DEMING WAY
MIDDLETON, WI
ZIP 53562-435
Phone: (608) 716-8288

The provider's authorized official is Paul Gilbert .
The authorized official title is Chief Legal Officer and has the following contact phone number (615) 716-4924.

The CLIA number assigned to this NPI record is 52D2225506 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/2/2022 and was last updated on 9/27/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100192621MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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