PEDIATRIC RADIOLOGIC SERVICES SC (NPI# 1184673964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184673964 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC RADIOLOGIC SERVICES SC |
| Practice Address |
9000 West Wisconsin Avenue Milwaukee WI 53201 |
| Mailing Address |
Po Box 230 Elm Grove WI 53122 |
| Practice Telephone | 4142661640 |
| Practice Fax Number | 4142661625 |
| Mailing Telephone | 2628219131 |
| Mailing Fax Number | 2628219132 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT G WELLS (OPERATING CHIEF) |
| Authorized Official Telephone | 4142661640 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 326-79000 | 05 |
| Street Address |
9000 WEST WISCONSIN AVENUE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366526444 | Leslie Marie Smith | Social Worker | 9000 West Wisconsin Avenue, Mail Station #750 Psychiatry and Behavioral Medicine Ch, Milwaukee, WI 53201-1997 | 2006-10-25 |
| 1477505832 | Jennifer L Brandt | Nurse Practitioner | 9000 West Wisconsin Avenue, Children's Health Sys Office Bldg, Milwaukee, WI 53226 | 2006-05-16 |
| 1083665822 | Jane Kivlin | Ophthalmology | 9000 West Wisconsin Avenue, Children's Hospital of Wisconsin, Milwaukee, WI 53226 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093262578 | Cathy Walls | Physical Therapist | 945 N. 12th St, Milwaukee, WI 53201 | 2016-09-01 |
| 1134393424 | Doreen L. Hernandez | Licensed Practical Nurse | 9000 W. Wisconsin Ave., Milw., WI 53201 | 2008-04-17 |
| 1033203948 | Deborah Bretl | Nurse Practitioner | 999 N 92nd St Suite 615, Milwaukee, WI 53201 | 2006-10-03 |
| 1558454272 | Thomas Walter Radmer | Dentist | 1801 West Wisconsin Av, Suite 106, Milwaukee, WI 53201 | 2006-10-02 |
| 1619956026 | Anthony F Graziano | Emergency Medicine | 945 North 12th Street, Milwaukee, WI 53201 | 2006-01-13 |
| 1194220558 | Jalel Abera Hunde | Student in an Organized Health Care Education/Training Program | 945 N. 12th Street, Milwaukee, WI 53201 | 2018-03-28 |
| 1487159273 | Solomon Wolde Zerga | Student in an Organized Health Care Education/Training Program | 945 N. 12th St., Milwaukee, WI 53201 | 2018-03-26 |
| 1467653279 | Siddesh V Besur | Internal Medicine | 2900 W. Oklahoma Avenue, Aurora St Luke's Medical Center, Milwaukee, WI 53201 | 2007-05-30 |
| 1578623906 | Kimberly L Gerlach | Psychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53201 | 2006-12-08 |
| 1255448510 | Teresa Anne Duchateau | Nurse Practitioner | 950 N 12th St, Milwaukee, WI 53201 | 2006-08-24 |
| Find all providers in zip 53201 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669814737 | Matthew William Shore | Radiology | 8915 W Connell Ave Dept Of, Milwaukee, WI 53226-3067 | 2013-07-18 |
| 1245538636 | Moira Ferrier Schieke | Radiology | 2542 N Terrace Ave, Milwaukee, WI 53211-3820 | 2011-03-09 |
| 1811127558 | Michael Orrin Griffin Jr. | Radiology | 9200 W. Wisconsin Ave., Department of Radiology, Milwaukee, WI 53226 | 2009-07-15 |
| 1598949026 | Deidre Meredith Rippl | Radiology | 2900 Oklahoma Ave, Milwaukee, WI 53215 | 2007-12-19 |
| 1053510115 | Petre Iosif Wecsler | Radiology | 7019 N Barnett Ln, Milwaukee, WI 53217-3606 | 2007-07-17 |
| 1285858019 | William Thomas Luckey | Radiology | 1545 W Spruce Ct, Milwaukee, WI 53217-1128 | 2007-04-12 |
| 1407957491 | Ferdinand M Brutvan | Radiology | 1925 E Iron St, Milwaukee, WI 53207-2315 | 2006-09-25 |
| 1295752251 | Sean R Amoli | Radiology | 6150 W Layton Ave, Milwaukee, WI 53220-4608 | 2006-07-16 |
| 1760416994 | Enhanced Medical Imaging Milwaukee LLC | Radiology | 7523 W Oklahoma Ave, Milwaukee, WI 53219-2861 | 2006-07-11 |
| 1396784948 | John Lammers | Radiology | 10400 W North Ave, Suite 300, Milwaukee, WI 53226-2425 | 2006-06-06 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.