Provider Demographics
NPI:1467598730
Name:PARTNERS IN EXCELLENCE INC
Entity Type:Organization
Organization Name:PARTNERS IN EXCELLENCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-405-2583
Mailing Address - Street 1:14301 EWING AVE S
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-4885
Mailing Address - Country:US
Mailing Address - Phone:952-746-5350
Mailing Address - Fax:952-746-6131
Practice Address - Street 1:14301 EWING AVE S
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-4885
Practice Address - Country:US
Practice Address - Phone:952-746-5350
Practice Address - Fax:952-746-6131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1225474570OtherNPI NUMBER - STEPHANY REETZ
1275960502OtherNPI NUMBER - KATHERINE SYTNIAK
MN1558521443OtherSANDRA MANNS NPI NUMBER
1659656429OtherNPI NUMBER - JENNA AVERBECK FORMERLY JENNA NIKULA
1891006599OtherNPI NUMBER - ELLEN HOXIE
1780988394OtherNPI NUMBER - AISHA BEYER
MNAN35342220001OtherCIGNA PROVIDER NUMBER
1215912662OtherJACQUELYN SCHMIDA NPI NUMBER
123522104OtherDR CHARLES MOORE NPI NUMBER
WI1528009560OtherSTATE OF WI PROVIDER # - JACQUELINE SCHMIDA
MN152D1PAOtherBCBS PROVIDER # EIBI SERVICES
1700944675OtherNPI # - GERARD LASALLE
MNLP1359OtherLICENSE # - GERARD LASALLE
1235282104OtherNPI # - DR. CHARLES M MOORE
1477987831OtherNPI NUMBER - KALA MCCLELLAN
MN475I4PAOtherBCBS OF MN PROVIDER ID# - SPEECH, LANGUAGE PATHOLOGY
WI1028.57OtherDR. CHARLES MOORE
1861764938OtherNPI # - ERICA BRANDAU
WI1028-57OtherWI STATE LICENSE - DR. CHARLES M MOORE
1467598730OtherPROVIDER ID# - STATE OF WI - PARTNERS IN EXCELLENCE
1821331570OtherNPI - CORTNEY WAKEFIELD
MN4DT59PAOtherBCBS PROVIDER ID # - LACROSSE SITE FOR EIBI SERVICES
11420695OtherCAQH PROVIDER ID# - DR CHARLES MOORE
WI651-154OtherJACKIE SCHMIDA WI LICENSE
MN70G18PAOtherBCBS OF MN PROVIDER ID# - OCCUPATIONAL THERAPY SERVICES
MNCZ31PAOtherBCBS PROVIDER ID # - LACROSSE SITE OCCUPATIONAL THERAPY SERVICES
MNAN35342220001OtherCIGNA PROVIDER NUMBER
1477987831OtherNPI NUMBER - KALA MCCLELLAN
MN102195OtherSTATE LICENSE - PAULA STOMMES
1235282104OtherNPI # - DR. CHARLES M MOORE
MN152D1PAOtherBCBS PROVIDER # EIBI SERVICES
1659656429OtherNPI # - JENNA NIKULA
WI651-154OtherJACKIE SCHMIDA WI LICENSE
MNLP1359OtherLICENSE # - GERARD LASALLE
WI1028-57OtherWI STATE LICENSE - DR. CHARLES M MOORE
1083934178OtherNPI NUMBER- KRISTIN DEMARTINO
123522104OtherDR CHARLES MOORE NPI NUMBER
1467598730OtherPROVIDER ID# - STATE OF WI - PARTNERS IN EXCELLENCE
285041OtherNBCOT# - SHANNON MATEER
MNCZ31PAOtherBCBS PROVIDER ID # - LACROSSE SITE OCCUPATIONAL THERAPY SERVICES
14060297OtherASHA NUMBER FOR MELANIE BRAVE
MN8539OtherSTATE LICENSE - SHARA WASSERMAN