CHILDREN'S HOSPITAL OF WISCONSIN, INC. (NPI# 1275961021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275961021 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S HOSPITAL OF WISCONSIN, INC. |
| Other Organization Name | CHW PAIN AND HEADACHE CLINIC |
| Practice Address |
9000 W Wisconsin Ave Pain Clinic and Headache Clinic Milwaukee WI 53226-4874 |
| Mailing Address |
9000 W Wisconsin Ave Mail Station 958 - Sheila Reuteman Milwaukee WI 53226-4874 |
| Practice Telephone | 4142663133 |
| Practice Fax Number | 4142661761 |
| Mailing Telephone | 4142667615 |
| Mailing Fax Number | 4142666238 |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2014-09-25 |
| Authorized Official Name | WELDON GAGE (TREASURER/CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4142666401 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHILDREN'S HOSPITAL OF WISCONSIN, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 3186-57 | WI | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 662-124 | WI | Behavioral Health & Social Service Providers |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1275961021 | 05 |
| Other Name | Type Code |
|---|---|
| CHW Pain and Headache Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881780302 | Children's Hospital of Wisconsin, Inc. | General Acute Care Hospital | 130 Second St, Neenah, WI 54956 | 2006-10-04 |
| 1629575709 | Children's Hospital of Wisconsin, Inc. | Pharmacy | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2018-04-06 |
| 1750482022 | Children's Hospital of Wisconsin, Inc. | Dentist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-3518 | 2006-09-26 |
| 1750489746 | Children's Hospital of Wisconsin, Inc. | Pharmacy | 9000 W Wisconsin Ave, Milwaukee, WI 53226-3518 | 2006-09-21 |
| 1952408353 | Children's Hospital of Wisconsin, Inc. | Clinic/Center | 9000 W Wisconsin Ave, Milwaukee, WI 53226-3518 | 2006-09-20 |
| 1962507228 | Children's Hospital of Wisconsin, Inc. | General Acute Care Hospital | 6308 8th Ave, Sixth Floor, Kenosha, WI 53143-5031 | 2006-09-13 |
| Street Address |
9000 W WISCONSIN AVE PAIN CLINIC AND HEADACHE CLINIC |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-4874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466928 | Deborah Costakos | Ophthalmology | 9000 W Wisconsin Ave, Pediatric Ophthalmology, Milwaukee, WI 53226-4874 | 2005-06-13 |
| 1477154748 | Tara Anne Peloza | Registered Nurse | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-11-04 |
| 1518567676 | Carolyn Mcnally Scoptur | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-10-28 |
| 1053910091 | Casey Wolter | Audiologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-10-21 |
| 1558976001 | Rachel Sawdy | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-11 |
| 1205441128 | Kathleen Maloney | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-09 |
| 1992319065 | Mariia Steffeny | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-04 |
| 1871106575 | Elisabeth Mary Vogt | Clinical Neuropsychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-08-24 |
| 1912517277 | Theresa Lauer Kapke | Psychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-08-03 |
| 1003425380 | Khira Ahmed-yahia | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003375049 | Sj Counseling Services, LLC | Clinic/Center | 7726 N 80th St, Milwaukee, WI 53223-3810 | 2019-03-19 |
| 1891976478 | Future Thoughts | Clinic/Center | 2623 N 53rd St, Milwaukee, WI 53210-2326 | 2007-11-24 |
| 1669518536 | Child & Adolescent Psychiatric Services, S.c. | Clinic/Center | 8989 N. Port Washington Rd., Suite 220, Milwaukee, WI 53217-1633 | 2007-01-29 |
| 1528344819 | Mark B. Smuckler Md Ltd | Clinic/Center | 155 E Silver Spring Dr, 203, Milwaukee, WI 53217-4704 | 2011-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754167 | Asap-behavioral Health, Sc | Clinic/Center | 11380 W Theo Trekr Way, West Allis, WI 53214-1135 | 2019-05-02 |
| 1295224657 | Northwest Counseling & Guidance Clinic | Clinic/Center | 123 S Van Buren, Green Bay, WI 54301-4441 | 2018-05-01 |
| 1801308218 | Northwest Counseling & Guidance Clinic | Clinic/Center | 915 Acacia Ln, Rhinelander, WI 54501-2806 | 2017-10-26 |
| 1790143667 | Northwest Counseling & Guidance Clinic | Clinic/Center | 1201 North 28th Street, Northwest Journey - Northern Lights, Superior, WI 54880-8556 | 2016-02-05 |
| 1417334988 | Willow Creek Ranch, Inc. | Clinic/Center | 7404 Northwest Hwy # 83, Mukwonago, WI 53149-8903 | 2015-05-04 |
| 1770985467 | Northwest Counseling & Guidance Clinic | Clinic/Center | 16092 Highway 63, Hayward, WI 54843-9775 | 2014-09-24 |
| 1700018389 | Saris Counseling LLC | Clinic/Center | 3416 Association Dr, Appleton, WI 54914 | 2009-08-17 |
| 1467626606 | Impact Counseling Services, LLC | Clinic/Center | 301 Ellis Ave, Suite 1, Ashland, WI 54806-1667 | 2008-04-18 |
| 1982821575 | Northwest Counseling and Guidance - Northwest Journey - Superior | Clinic/Center | 1419 Hill Ave Ste B, Superior, WI 54880-1951 | 2007-04-18 |
| 1184746828 | University of Wisconsin System Non Payroll | Clinic/Center | 122 E Olin Ave Ste 255, Madison, WI 53713 | 2007-04-04 |
| Find all providers with the same taxonomy | ||||
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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.