LISA M PETERSON (NPI# 1336131986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336131986 |
Entity Type | Individual |
Full Name | LISA M PETERSON |
Credential | D.O. |
Practice Address |
180 W Grange Ave Milwaukee WI 53207-6030 |
Practice Telephone | 4147477730 |
Practice Fax Number | 4147477722 |
Mailing Telephone | 4147477730 |
Mailing Fax Number | 4147477722 |
Enumeration Date | 2005-08-19 |
Last Update Date | 2019-04-10 |
NPI Deactivation Date | 03/21/2006 |
NPI Reactivation Date | 2006-04-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
42769 | WI | Allopathic & Osteopathic Physicians |
N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
42769 | WI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 43548700 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265952592 | Lisa Peterson | Physical Therapy Assistant | 893 94th St, Pleasant Prairie, WI 53158-4911 | 2017-06-27 |
1497154033 | Lisa Peterson | Speech-Language Pathologist | 407 N Foster St, Center, MO 63436-1026 | 2014-08-20 |
1528467503 | Lisa Peterson | Marriage & Family Therapist | 3240 W Foster Ave, Suite A, Chicago, IL 60625-4828 | 2014-08-15 |
1518204734 | Lisa Lynn Peterson | Counselor | 405 Goldridge Dr, Georgetown, TX 78633-1989 | 2013-01-08 |
1790056554 | Lisa Peterson | Nurse Practitioner | 12629 Se 54th St, Bellevue, WA 98006-2916 | 2012-01-25 |
1265697676 | Lisa Ann Peterson | Social Worker | 8366 Mary Lee Ln, Laurel, MD 20723-1192 | 2008-07-24 |
1619156411 | Lisa M Peterson | Physician Assistant | 1500 14th St W Ste 300, Williston, ND 58801-4079 | 2007-10-29 |
1962514869 | Lisa A Peterson | Counselor | 110 Elmwood Ave, Providence, RI 02907-2423 | 2006-08-31 |
1154983682 | Lisa Marie Peterson | Counselor | 784 High St, San Luis Obispo, CA 93401-5243 | 2019-07-04 |
1013480631 | Lisa Jane Peterson | Speech-Language Pathologist | 3430 Burnet Ave # 4011, Cincinnati, OH 45229-2833 | 2019-01-07 |
Street Address |
180 W GRANGE AVE |
City | MILWAUKEE |
State | WI |
Zip Code | 53207-6030 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376568006 | Aurora Pharmacy Inc | Pharmacy | 180 W Grange Ave, Milwaukee, WI 53207-6030 | 2006-07-13 |
1093765612 | David A Rein | Internal Medicine | 180 W Grange Ave, Milwaukee, WI 53207-6030 | 2006-05-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497304117 | Diane Wisch | Technician | 3602 S. 4th, Mil, WI 53207 | 2019-09-05 |
1811384464 | Megan O Bedolla | Emergency Medicine | 2338 E Ohio Ave, Milwaukee, WI 53207 | 2015-04-21 |
1255677563 | Jon Arthur Toppen | Counselor | 2637 S Fulton St, Milwaukee, WI 53207 | 2012-12-14 |
1720316730 | Paula Maria Ortega Flores | Massage Therapist | 2121 South Kinnickinnic Ave, Suite 3, Milwaukee, WI 53207 | 2009-12-02 |
1306087127 | Theron Mills | Counselor | 3073 S. Chase Ave., Suite 326, Milwaukee, WI 53207 | 2009-03-09 |
1841438769 | Counseling & Transition Center Inc | Clinic/Center | 3073 S. Chase Ave, Suite 326, Milwaukee, WI 53207 | 2009-01-30 |
1679727812 | Well-rounded, LLC | Clinic/Center | 2455 S. Howell Ave., Milwaukee, WI 53207 | 2008-11-14 |
1316154024 | Christian T. Harteau | Student in an Organized Health Care Education/Training Program | 3174 S Howell Ave, Milwaukee, WI 53207 | 2007-05-16 |
1316008303 | Thomas Fisher | Clinical Neuropsychologist | 2419 S. Lenox Street, Milwaukee, WI 53207 | 2006-12-13 |
1750470811 | David Alan Duter | Technician, Other | Uscg Sector Lake Michigan/hs Div, 2420 S. Lincoln Memorial Dr., Milwaukee, WI 53207 | 2006-10-12 |
Find all providers in zip 53207 |
Taxonomy Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093948895 | Ricardo Sanga | Internal Medicine | 106 W Seeboth St Unit 1101, Milwaukee, WI 53204-4331 | 2009-08-26 |
1811001720 | Tasleem Raza | Internal Medicine | Clement J Zablocki Veterans Affairs Medical Ctr, 5000 W. National Avenue, Milwaukee, WI 53295-0001 | 2006-08-18 |
1740241793 | Raed A Hamed | Internal Medicine | 8500 W Capitol Dr, Suite 202b, Milwaukee, WI 53222-1869 | 2006-03-30 |
1538556766 | Chidinma L Onweni | Internal Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2015-04-26 |
1215355011 | Mark Barash | Internal Medicine | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2014-03-31 |
1174949523 | Abbas Ali Md Sc | Internal Medicine | 7733 W Burleigh St, Milwaukee, WI 53222-5003 | 2014-03-10 |
1295171833 | Ruth L Musselman | Internal Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215 | 2013-05-21 |
1265775993 | Jason Scott Prudom | Internal Medicine | 3201 S 16th St Ste 2015, Milwaukee, WI 53215-4532 | 2013-04-01 |
1023366010 | Mihir S Shah | Internal Medicine | 2901 W Kinnickinnic River Pkwy Ste 315, Milwaukee, WI 53215-3660 | 2012-08-22 |
1154699072 | Raed Hamed Md LLC | Internal Medicine | 8500 W Capitol Dr, Suite 202b, Milwaukee, WI 53222-1869 | 2011-12-06 |
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.