WISCONSIN MEDICAL GROUP (NPI# 1326599945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326599945 |
| Entity Type | Organization |
| Organization Name | WISCONSIN MEDICAL GROUP |
| Practice Address |
8800 W Lincoln Ave West Allis WI 53227-2400 |
| Mailing Address |
14295 Woodmount Dr Brookfield WI 53005-2390 |
| Practice Telephone | 2623399797 |
| Mailing Telephone | 2623399797 |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |
| Authorized Official Name | HALEY KEHOE (OWNER) |
| Authorized Official Telephone | 2623399797 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5440321 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
8800 W LINCOLN AVE |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227-2400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659939734 | Milan Mrkalj | Physical Therapist | 8800 W Lincoln Ave, West Allis, WI 53227-2400 | 2019-06-03 |
| 1558929638 | Viktor Gottlieb | Physical Therapist | 8800 W Lincoln Ave, West Allis, WI 53227-2400 | 2019-06-03 |
| 1639683220 | Niccole Rietveld | Physical Therapy Assistant | 8800 W Lincoln Ave, West Allis, WI 53227-2400 | 2017-11-19 |
| 1538699046 | Danra Chang | Physical Therapy Assistant | 8800 W Lincoln Ave, West Allis, WI 53227-2400 | 2017-06-16 |
| 1063957629 | Michael H Lembezeder | Physical Therapist | 8800 W Lincoln Ave, West Allis, WI 53227-2400 | 2017-01-05 |
| 1942745039 | Aleksandar Gligorevic | Physical Therapy Assistant | 8800 W Lincoln Ave, West Allis, WI 53227-2400 | 2016-12-27 |
| 1336496215 | Frank Rewolinski | Physical Therapist | 8800 W Lincoln Ave, West Allis, WI 53227-2400 | 2012-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992150148 | Brittani S Gierisch | Family Medicine | 2424 S 90th St # 7795, West Allis, WI 53227-2455 | 2016-04-25 |
| 1831516160 | Stephanie Kay Mcdearmon | Family Medicine | 2424 S 90th St Ste 200, West Allis, WI 53227-2455 | 2014-03-25 |
| 1295909075 | Haley E Kehoe | Family Medicine | 8800 West Lincoln Ave Suite 100, West Allis, WI 53227 | 2008-04-14 |
| 1689728602 | Masroor Munim Md | Family Medicine | 7200 W Greenfield Avenue, West Allis, WI 53214 | 2007-01-23 |
| 1538247051 | David S Stolp | Family Medicine | 2424 S. 90th St., Ste 214, West Allis, WI 53227-2455 | 2006-11-01 |
| 1043327505 | Paul Gordon Malen | Family Medicine | 2323 S 109th St, #220, West Allis, WI 53227 | 2006-08-23 |
| 1215942867 | Rachael Weiderhold D.o. Inc | Family Medicine | 9004 W Lincoln Ave, Suite 101, West Allis, WI 53227-2452 | 2006-07-30 |
| 1215981733 | Theresa Marie Pardoe | Family Medicine | 9305 W National Ave, West Allis, WI 53227-1541 | 2006-05-20 |
| 1568437390 | Bernard Zaworski | Family Medicine | 2514 S 102nd St, Suite 160, West Allis, WI 53227-2142 | 2006-02-23 |
| 1770589202 | Patricia Ivonne Hago | Family Medicine | 801 S 70th St, West Allis, WI 53214-3147 | 2005-06-21 |
| Find all providers in WEST ALLIS | ||||
| City | WEST ALLIS |
| Zip Code | 53227 |
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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.