| Mountains Edge Medical Group Pllc | |
|
333 E 2nd St Richland Center WI 53581 | |
| (608) 647-6321 | |
| Not Available |
| Full Name | Mountains Edge Medical Group Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 333 E 2nd St, Richland Center, Wisconsin |
| Authorized Official Name and Position | Matthew Pappy (SOLE OWNER) |
| Authorized Official Contact | 4057405017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountains Edge Medical Group Pllc 2660 Crimson Canyon Dr Ste 130 Las Vegas NV 89128-0846 Ph: (702) 453-3799 | Mountains Edge Medical Group Pllc 333 E 2nd St Richland Center WI 53581 Ph: (608) 647-6321 |
| NPI Number | 1316496383 |
|---|---|
| Provider Enumeration Date | 09/30/2016 |
| Last Update Date | 12/29/2022 |
| Medicare PECOS PAC ID | 1658659842 |
|---|---|
| Medicare Enrollment ID | O20161229000940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316496383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD60688815 (Washington) | Secondary |
| 207Q00000X | Family Medicine | DR0057605 (Colorado) | Secondary |
| 207Q00000X | Family Medicine | 66303 (Wisconsin) | Primary |
| Provider Name | Matthew Pappy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164783700 PECOS PAC ID: 9638485873 Enrollment ID: I20161229001011 |
| Provider Name | Michelle Pappy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235490871 PECOS PAC ID: 2769783612 Enrollment ID: I20220302001838 |
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