Open Space LLC
NPI 1194553404ActiveOrganization· Counselor, Professional· Madison, WI
Counselor, Professional in Madison, Wisconsin, registered in NPPES in July 2024. The authorized official on file is Sara Jordan, Owner/Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1194553404 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 26, 2024 |
| Last updated in NPPES | Jul 26, 2024 |
| Certified by provider | Jul 26, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WI) |
|---|
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