GREAT LAKES FOOT & ANKLE OF GREATER MILWAUKEE (NPI# 1316101595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316101595 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES FOOT & ANKLE OF GREATER MILWAUKEE |
| Practice Address |
8153 S 27th St 400 Franklin WI 53132-9549 |
| Practice Telephone | 4147610981 |
| Mailing Telephone | 4147610981 |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2010-12-27 |
| Authorized Official Name | DR. ROBERT D MATTEUCCI (MANAGER) |
| Authorized Official Telephone | 4147610981 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP1100X |
Clinic/Center Specialization: Podiatric |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1316101595 | 05 | |
| WI | PTAN | WI1772 | 01 |
| Street Address |
8153 S 27TH ST 400 |
| City | FRANKLIN |
| State | WI |
| Zip Code | 53132-9549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164426763 | Robert D Matteucci | Podiatrist | 8153 S 27th St, Suite 400, Franklin, WI 53132-9549 | 2005-06-10 |
| 1730689548 | Sports Physical Therapy & Rehab Specialist, S.c. | Physical Therapist | 8153 S 27th St, Franklin, WI 53132-9549 | 2018-02-19 |
| 1548679046 | Glsd Medical LLC | Clinic/Center | 8153 S 27th St, Suite 500, Franklin, WI 53132-9549 | 2014-08-08 |
| 1558674028 | Douglas Milosavljevic, M.d., S.c. | Anesthesiology | 8153 S 27th St, Suite 300, Franklin, WI 53132-9549 | 2010-07-26 |
| 1649401258 | Great Lakes Pain Specialists, LLC | Anesthesiology | 8153 S 27th St, Franklin, WI 53132-7012 | 2009-07-30 |
| 1497980759 | Great Lakes Medical LLC | Clinic/Center | 8153 S 27th St, Franklin, WI 53132-7012 | 2009-05-15 |
| 1831173822 | Douglas Milosavljevic | Anesthesiology | 8153 S 27th St, Suite 500, Franklin, WI 53132-9549 | 2005-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568014405 | Michelle L. Lamers, D.d.s, L.L.C. | Dentist | 7111 S 76 Street, Franklin, WI 53132 | 2019-07-11 |
| 1649833765 | Lori A Mansur | Registered Nurse | 6580 S. 46th St., Franklin, WI 53132 | 2019-04-15 |
| 1619496296 | Emily Ninnemann | Occupational Therapist | 8940 S. 51st St, Franklin, WI 53132 | 2017-09-14 |
| 1639532526 | Rinal Patel | Emergency Medicine | 9200 W Loomis Rd Ste 212, Franklin, WI 53132 | 2016-03-30 |
| 1174980098 | Lisa Obrien | Registered Nurse | 3111 W Rawson Ave Ste 210, Franklin, WI 53132 | 2016-01-22 |
| 1528446713 | Jonathan Shih | Podiatrist | 9200 W Loomis Rd Ste 116, Franklin, WI 53132 | 2015-05-08 |
| 1275940769 | Tristan Krause | Nurse Practitioner | 4225 W. Oakwood Park Court, Franklin, WI 53132 | 2014-07-16 |
| 1922344613 | Vital Imaging, LLC | Clinic/Center | 10500 W. Loomis Rd., Ste 130, Franklin, WI 53132 | 2012-12-27 |
| 1013285311 | Jill Barth | Pharmacist | 7130 South 76th Street, Franklin, WI 53132 | 2011-12-01 |
| 1235417783 | Hilary Megan Mayne | Dentist | 6855 South 27th St, Franklin, WI 53132 | 2011-08-02 |
| Find all providers in zip 53132 | ||||
| Taxonomy Code | 261QP1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Podiatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679608392 | Advanced Foot & Ankle of Wisconsin LLC | Clinic/Center | 1050 S Milwaukee Avenue, Ste 102, Burlington, WI 53105-5310 | 2007-02-22 |
| 1295837425 | Mark P Hastings, Dpm, Sc | Clinic/Center | 3431 N 51st Blvd, Milwaukee, WI 53216-3228 | 2006-09-01 |
| 1033115456 | Sokaogon Chippewa Community | Clinic/Center | 3144 Vanzile Rd, Crandon, WI 54520-8149 | 2005-06-21 |
| 1114385960 | Mark A. Aldrich, D.p.m., Inc. | Clinic/Center | 737 Dorr St, Antigo, WI 54409-1472 | 2016-02-09 |
| 1679987788 | Elite Foot & Ankle Clinic Sc | Clinic/Center | 1779 Main St, Green Bay, WI 54302-3250 | 2014-06-17 |
| 1932454279 | Podomedik Clinics LLC. | Clinic/Center | 2727 W Cleveland Ave, Suite 100, Milwaukee, WI 53215-2956 | 2012-07-23 |
| 1689976474 | Aspirus Clinics Inc | Clinic/Center | 1445 Merrill Ave, Wausau, WI 54401-2646 | 2010-11-30 |
| 1295042711 | Yomex LLC | Clinic/Center | 2525 N Mayfair Rd, Suite #80, Wauwatosa, WI 53226-1403 | 2010-09-03 |
| 1437327475 | Glenn A. Hansen, D.p.m. | Clinic/Center | 2331 S Oneida St, Green Bay, WI 54304-5267 | 2008-02-12 |
| 1710162003 | Renard Foot & Ankle Specialist LLC | Clinic/Center | 2005 S. Lake Park Rd, Appleton, WI 54915 | 2008-01-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on GREAT LAKES FOOT & ANKLE OF GREATER MILWAUKEE.
| 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.