| Details | Last Recertification Date | Update | Recertification | 5/8/2024 8:02:06 AM | 5/6/2025 9:42:40 AM | 5/6/2025 9:42 AM |
| Details | Nature of Support: In Kind Support Description | Insert | Group Change Request | | section 318 funds, State of WI STI grant | 3/26/2025 10:23 AM |
| Details | Nature Of Support | Insert | Group Change Request | | In-Kind products or services (see note below; must have been purchased with section 318 funds) | 3/26/2025 10:23 AM |
| Details | Nature of Support: Support Received From Date | Insert | Group Change Request | | 2/28/2025 12:00:00 AM | 3/26/2025 10:23 AM |
| Details | Nature of Support: Support Received To Date | Insert | Group Change Request | | 2/28/2026 12:00:00 AM | 3/26/2025 10:23 AM |
| Details | Nature Of Support | Delete | Group Change Request | Direct Funding (dollars received from CDC or an intermediate organization) (01/01/2023)-(01/31/2025) | | 3/26/2025 10:23 AM |
| Details | Grant Number | Update | Group Change Request | 6 NH25PS005148-05-05 | NH25PS005148 | 3/26/2025 10:23 AM |
| Contacts | Authorizing Official | Update | Group Change Request | Tarpey, Kathryn
Director of Finance
Planned Parenthood of WI, Inc.
4142893717 | Odegaard, Susan
Director of Business Operations
Planned Parenthood of WI, Inc.
4142893796 | 10/31/2024 8:27 AM |
| Details | Last Recertification Date | Update | Recertification | 5/17/2023 8:22:04 AM | 5/8/2024 8:02:06 AM | 5/8/2024 8:02 AM |
| Details | Nature of Support: Support Received To Date | Update | Group Change Request | 12/31/2023 12:00:00 AM | 1/31/2025 12:00:00 AM | 2/21/2024 7:35 AM |
| Details | Grant Number | Update | Group Change Request | NH25PS005148 | 6 NH25PS005148-05-05 | 2/21/2024 7:35 AM |
| Details | Nature of Support: Support Received From Date | Update | Recertification | 1/1/2022 12:00:00 AM | 1/1/2023 12:00:00 AM | 5/17/2023 8:22 AM |
| Details | Nature of Support: Support Received To Date | Update | Recertification | 12/31/2022 12:00:00 AM | 12/31/2023 12:00:00 AM | 5/17/2023 8:22 AM |
| Details | Last Recertification Date | Update | Recertification | 5/17/2022 12:58:26 PM | 5/17/2023 8:22:04 AM | 5/17/2023 8:22 AM |
| Details | Grant Number | Update | Recertification | 6 NH25PS005148-04-01 | NH25PS005148 | 5/17/2023 8:22 AM |
| Details | Nature of Support: Support Received From Date | Update | Recertification | 1/1/2021 12:00:00 AM | 1/1/2022 12:00:00 AM | 5/17/2022 12:58 PM |
| Details | Nature of Support: Support Received To Date | Update | Recertification | 12/31/2021 12:00:00 AM | 12/31/2022 12:00:00 AM | 5/17/2022 12:58 PM |
| Details | Last Recertification Date | Update | Recertification | 5/4/2021 8:24:46 AM | 5/17/2022 12:58:26 PM | 5/17/2022 12:58 PM |
| Details | Grant Number | Update | Recertification | NH25PS005148 | 6 NH25PS005148-04-01 | 5/17/2022 12:58 PM |
| Contacts | Authorizing Official | Update | Group Change Request | Williams, Chris
COO
PLANNED PARENTHOOD OF WI, INC.
4142893738 | Tarpey, Kathryn
Director of Finance
Planned Parenthood of WI, Inc.
4142893717 | 2/25/2022 9:31 AM |
| Details | Nature of Support: Support Received From Date | Update | Recertification | | 1/1/2021 12:00:00 AM | 5/4/2021 8:24 AM |
| Details | Nature of Support: Support Received To Date | Update | Recertification | | 12/31/2021 12:00:00 AM | 5/4/2021 8:24 AM |
| Medicaid Billing | NPI: State | Update | Recertification | | WI | 5/4/2021 8:24 AM |
| Details | Last Recertification Date | Update | Recertification | 5/3/2020 5:19:01 PM | 5/4/2021 8:24:46 AM | 5/4/2021 8:24 AM |
| Details | NOFO Number | Update | Recertification | | PS19-1901 | 5/4/2021 8:24 AM |
| Details | Last Recertification Date | Update | Recertification | 5/14/2019 10:46:21 AM | 5/3/2020 5:19:01 PM | 5/3/2020 5:19 PM |
| Details | Grant Number | Update | Change Request | 1 NH25PS005148-01-00 | NH25PS005148 | 4/27/2020 8:22 AM |
| Details | Last Recertification Date | Update | Recertification | 5/1/2018 3:41:40 PM | 5/14/2019 10:46:21 AM | 5/14/2019 10:46 AM |
| Details | Grant Number | Update | Recertification | 5NH25PS004336-05-00 | 1 NH25PS005148-01-00 | 5/14/2019 10:46 AM |
| Details | Last Recertification Date | Update | Recertification | 5/3/2017 12:00:00 AM | 5/1/2018 3:41:40 PM | 5/1/2018 3:41 PM |
| Details | Grant Number | Update | Recertification | 5NH25PS004336-04-00 | 5NH25PS004336-05-00 | 5/1/2018 3:41 PM |
| Contacts | Authorizing Official | Update | Change Request | Tollakson, Brian
CFO
Planned Parenthood of Wisconsin, Inc.
4142893728 | Williams, Chris
COO
PLANNED PARENTHOOD OF WI, INC.
4142893738 | 3/14/2018 12:09 PM |
| Addresses | Shipping Address | Insert | Change Request | | PLANNED PARENTHOOD OF WI, INC.
967 W. Clairemont Ave.
EAU CLAIRE, WI 54701 | 10/12/2017 1:07 PM |
| Addresses | Shipping Address | Insert | Change Request | | PLANNED PARENTHOOD OF WI INC.
302 N. JACKSON STREET
MILWAUKEE, WI 53202 | 10/12/2017 1:07 PM |
| Contacts | Authorizing Official | Update | | Tollakson, Brian
CFO
4142893728 | Tollakson, Brian
CFO
Planned Parenthood of Wisconsin, Inc.
4142893728 | 9/27/2017 11:38 AM |
| Contacts | Primary Contact | Update | | BURRAGE, CHARLEEN
PURCHASING COORDINATOR
4142893706 | BURRAGE, CHARLEEN J
PURCHASING COORDINATOR
PLANNED PARENTHOOD OF WI, INC.
4142893706 | 9/26/2017 11:13 AM |
| Contacts | Authorizing Official | Insert | | | Tollakson, Brian
CFO
4142893728 | 5/3/2017 7:59 PM |
| Contacts | Primary Contact | Insert | | | BURRAGE, CHARLEEN
PURCHASING COORDINATOR
4142893706 | 5/3/2017 7:59 PM |
| Addresses | Main Address | Insert | | |
967 W. Clairemont Ave.
EAU CLAIRE, WI 54701 | 5/3/2017 11:12 AM |
| Details | Last Recertification Date | Update | | 2/12/2016 12:00:00 AM | 5/3/2017 12:00:00 AM | 5/3/2017 11:12 AM |
| Details | Grant Number | Update | | STD-WI | 5NH25PS004336-04-00 | 5/3/2017 11:12 AM |
| Addresses | Billing Address | Insert | | | PLANNED PARENTHOOD OF WI, INC.
302 N. JACKSON STREET
MILWAUKEE, WI 53202 | 5/31/2016 9:30 AM |
| Medicaid Billing | Medicaid: Is Primary | Update | | True | False | 2/12/2016 2:32 PM |
| Details | Last Recertification Date | Update | | 2/9/2015 12:00:00 AM | 2/12/2016 12:00:00 AM | 2/12/2016 2:32 PM |
| Details | Nature Of Support | Insert | | | Direct Funding (dollars received from CDC or an intermediate organization) | 2/9/2015 3:16 PM |
| Details | Last Recertification Date | Update | | 2/20/2014 12:00:00 AM | 2/9/2015 12:00:00 AM | 2/9/2015 3:16 PM |
| Details | Last Recertification Date | Update | | 1/1/2012 12:00:00 AM | 2/20/2014 12:00:00 AM | 2/20/2014 11:24 AM |
| Details | Last Recertification Date | Update | | 1/1/2011 12:00:00 AM | 1/1/2012 12:00:00 AM | 12/8/2011 11:55 AM |
| Details | Entity Subname | Update | | EAU CLAIRE CENTER | PPWI - EAU CLAIRE HEALTH CENTER | 12/8/2011 11:55 AM |
| Details | Comments Public | Insert | | | 12/8/11 update subdiv name (was EAU CLAIRE CENTER); 12/10/08 ADDED MEDICAID #; 12/5/07 UPDATED BILL TO; 9/22/04 UPDATED MEDICAID # (WAS 42006900) | 12/8/2011 11:55 AM |
| Details | Last Recertification Date | Insert | | | 1/1/2011 12:00:00 AM | 11/19/2010 4:49 PM |
| Details | Grant Number | Insert | | | STD-WI | 11/19/2010 4:49 PM |
| Details | 340B ID | Insert | | | STD54703Q | 11/19/2010 4:49 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 11/19/2010 4:49 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 11/19/2010 4:49 PM |
| Details | Medicare Provider Number | Insert | | | | 11/19/2010 4:49 PM |
| Details | Entity Name | Insert | | | PLANNED PARENTHOOD OF WI INC. | 11/19/2010 4:49 PM |
| Details | Program Code | Insert | | | STD | 11/19/2010 4:49 PM |
| Details | Entity Subname | Insert | | | EAU CLAIRE CENTER | 11/19/2010 4:49 PM |
| Dates | Participating Approval Date | Insert | | | 11/18/2004 12:00:00 AM | 11/19/2010 4:49 PM |
| Details | State | Insert | | | Active | 11/19/2010 4:49 PM |
| Dates | Registration Date | Insert | | | 10/1/2002 12:00:00 AM | 11/19/2010 4:49 PM |
| Dates | Signed By Date | Insert | | | 1/1/2011 12:00:00 AM | 11/19/2010 4:49 PM |
| Dates | Start Date | Insert | | | 10/1/2002 12:00:00 AM | 11/19/2010 4:49 PM |
| Terminations | Termination Comments | Insert | | | | 11/19/2010 4:49 PM |
| Terminations | Termination Date | Insert | | | | 11/19/2010 4:49 PM |
| Terminations | Termination Effective Date | Insert | | | | 11/19/2010 4:49 PM |
| Terminations | Termination Reason | Insert | | | | 11/19/2010 4:49 PM |
| Details | Comments Public | Insert | | | 12/10/08 ADDED MEDICAID #; 12/5/07 UPDATED BILL TO; 9/22/04 UPDATED MEDICAID # (WAS 42006900) | 11/19/2010 4:49 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | | | True | 10/1/2002 12:00 AM |
| Medicaid Billing | Medicaid: Number | Insert | | | 42006100 | 10/1/2002 12:00 AM |
| Medicaid Billing | Medicaid: State | Insert | | | WI | 10/1/2002 12:00 AM |
| Medicaid Billing | NPI: Number | Insert | | | 1255506754 | 10/1/2002 12:00 AM |