CHILDREN'S HOSPITAL OF WISCONSIN (NPI# 1194064865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194064865 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S HOSPITAL OF WISCONSIN |
| Other Organization Name | CHILD ADVOCACY CENTER - RACINE |
| Practice Address |
2405 Northwestern Ave Suite 205 Racine WI 53404-2534 |
| Mailing Address |
9000 W Wisconsin Ave Ms 958 Milwaukee WI 53226-4874 |
| Practice Telephone | 2628987970 |
| Practice Fax Number | 2628986621 |
| Mailing Telephone | 4142667615 |
| Mailing Fax Number | 4142666238 |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2013-09-27 |
| Authorized Official Name | WELDON GAGE (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 4142666401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Child Advocacy Center - Racine | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992810667 | Children's Hospital of Wisconsin | General Acute Care Hospital | 9000 W Wisconsin Ave Msc 750, Milwaukee, WI 53226-3518 | 2006-08-20 |
| 1689787541 | Children's Hospital of Wisconsin | Audiologist | W147n10748 Heritage Pkwy, Germantown, WI 53022-4389 | 2006-08-16 |
| 1962003707 | Children's Hospital of Wisconsin | Counselor | 8800 Washington Ave, Mount Pleasant, WI 53406-3701 | 2020-11-06 |
| 1346727443 | Children's Hospital of Wisconsin | Pediatrics | 134 S Foster Dr, Saukville, WI 53080-2005 | 2018-07-23 |
| 1760819312 | Children's Hospital of Wisconsin | Pediatrics | W4063 Hwy Nn, Elkhorn, WI 53121-4338 | 2013-09-27 |
| 1649519299 | Children's Hospital of Wisconsin | Pediatrics | 8500 75th St, Kenosha, WI 53142-8213 | 2013-02-01 |
| 1386983930 | Children's Hospital of Wisconsin | Pediatrics | 503 S Monroe Ave, Green Bay, WI 54301-4017 | 2013-02-01 |
| 1275872822 | Children's Hospital of Wisconsin | Pediatrics | 726 N East Ave, Waukesha, WI 53186-4807 | 2013-02-01 |
| 1700125481 | Children's Hospital of Wisconsin | Pediatrics | 325 N Commercial St, Suite 400, Neenah, WI 54956-2665 | 2013-01-31 |
| 1831437581 | Children's Hospital of Wisconsin | Pediatrics | 619 W Walnut St, Milwaukee, WI 53212-3839 | 2013-01-30 |
| Street Address |
2405 NORTHWESTERN AVE SUITE 205 |
| City | RACINE |
| State | WI |
| Zip Code | 53404-2534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235246521 | Jeffrey H Schulz | Counselor | 2405 Northwestern Ave, Racine, WI 53404-2534 | 2006-08-24 |
| 1326423534 | Tereo Narcotic Treatment Center, LLC | Clinic/Center | 2405 Northwestern Ave, Suite Lower Level, Racine, WI 53404-2534 | 2015-07-29 |
| 1104257013 | Nancy E Flores | Social Worker | 2405 Northwestern Ave, Racine, WI 53404-2534 | 2013-12-02 |
| 1548606767 | Byron Health and Healing Center | Family Medicine | 2405 Northwestern Ave, Lower Level, Ste 15, Racine, WI 53404-2534 | 2013-05-14 |
| 1043562838 | Maryellen L. Schemel | Counselor | 2405 Northwestern Ave, Suite Ll5, Racine, WI 53404-2534 | 2012-10-04 |
| 1316299209 | Cory M Rozewicz | Dental Hygienist | 2405 Northwestern Ave, Racine, WI 53404-2534 | 2012-10-03 |
| 1982951679 | Harvest Consulting Company, LLC | Community/Behavioral Health | 2405 Northwestern Ave, Lower Level Suite 5, Racine, WI 53404-2534 | 2012-08-13 |
| 1720310261 | Rebecca Michelle Patton | Social Worker | 2405 Northwestern Ave, Suite 205, Racine, WI 53404-2534 | 2010-02-09 |
| 1154557643 | Stefanie M Graham | Dental Hygienist | 2405 Northwestern Ave, Racine, WI 53404-2534 | 2009-06-10 |
| 1841445699 | Dolores Diane Prince | Dental Hygienist | 2405 Northwestern Ave, Racine, WI 53404-2534 | 2008-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033686001 | Rosamaria E Garcia | Registered Nurse | 1120 Hartman Ct, Racine, WI 53404 | 2018-10-29 |
| 1912372418 | Avada Audiology and Hearing Care | Preferred Provider Organization | 813 Fox Lane Suite B, Waterford, WI 53404 | 2015-12-09 |
| 1215095096 | Bonnie Lee Wirfs | Internal Medicine | 2000 Domanik Drive, Racine, WI 53404 | 2006-12-05 |
| 1992813893 | Craig E Fleury | Dentist | 7117 Green Bay Road, Racine, WI 53404 | 2006-08-29 |
| 1174631089 | Greg L Smart | Dentist | 7117 Green Bay Road, Racine, WI 53404 | 2006-08-29 |
| 1871953950 | Amybeth Mahoney | Counselor | 4726 N Green Bay Rd, Racine, WI 53404-1108 | 2016-03-02 |
| 1649560871 | Abby Healthcare Staffing, LLC | Home Health | 3406 Killips Ln, Racine, WI 53404-1310 | 2011-04-08 |
| 1114071917 | Ib Thostrup | Chiropractor | 2827 Rapids Dr, Racine, WI 53404-1620 | 2007-01-22 |
| 1417001140 | Thostrup Chiropractic, S.c. | Chiropractor | 2827 Rapids Dr, Racine, WI 53404-1620 | 2007-01-22 |
| 1578620423 | Sally Jean Brown | Chiropractor | 2609 Rapids Dr, Racine, WI 53404-1741 | 2007-01-02 |
| Find all providers in zip 53404 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225409048 | Lotus Comprehensive Health Care, Sc | Pediatrics | 2010 Indiana St, Racine, WI 53405-3651 | 2015-10-20 |
| 1518127463 | Peter August Gardetto | Pediatrics | 475 Windridge Dr, Racine, WI 53402-2658 | 2008-06-13 |
| 1134324502 | Katherine Furman Canfield | Pediatrics | 3821 Spring St, Racine, WI 53405-1667 | 2007-06-18 |
| 1548472657 | Kristen Wasilowski Cook | Pediatrics | 3807 Spring St, Racine, WI 53405-1667 | 2007-05-03 |
| 1164566972 | Leslie M Hertz | Pediatrics | 3807 Spring St, Racine, WI 53405-1667 | 2007-02-16 |
| 1891806873 | Joy Briggs | Pediatrics | 3807 Spring St, Racine, WI 53405-1667 | 2006-08-31 |
| 1013930106 | Jeffrey Naus | Pediatrics | 3807 Spring St, Racine, WI 53405-1667 | 2006-07-26 |
| 1346264470 | Willard Nettles | Pediatrics | 3807 Spring St, Racine, WI 53405-1667 | 2006-07-26 |
| 1598788283 | George Milonas | Pediatrics | 3807 Spring St, Racine, WI 53405-1667 | 2006-07-25 |
| 1982627642 | Scott W. Meyer | Pediatrics | 3807 Spring St, Racine, WI 53405-1667 | 2006-07-25 |
| Find all providers in RACINE | ||||
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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.