STACY PETERSON (NPI# 1356515704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356515704 |
| Entity Type | Individual |
| Full Name | STACY PETERSON |
| Credential | M.D. |
| Practice Address |
9000 W Wisconsin Ave Milwaukee WI 53226-4874 |
| Practice Telephone | 4142663560 |
| Practice Fax Number | 4142666092 |
| Mailing Telephone | 4142663560 |
| Mailing Fax Number | 4142666092 |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2019-12-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 52973 | WI | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
52973 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1356515704 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 959 N Mayfair Rd, Mcw Pain Management Center, Milwaukee, WI 532263465 | 4149557601 | 4149556020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992259519 | Stacy Peterson | Counselor | 2 5th St N Ste 202, Great Falls, MT 59401-4011 | 2016-08-11 |
| 1518234913 | Stacy Elizabeth Peterson | Speech-Language Pathologist | 1004 Inwood Dr, Hurst, TX 76053-4129 | 2011-11-29 |
| 1922522838 | Stacy Peterson | Social Worker | 9409 N Haggerty Rd, Plymouth, MI 48170-4696 | 2017-08-01 |
| 1730627571 | Stacy Peterson | Behavior Technician | 355 Citrus Tower Blvd, Suite 116, Clermont, FL 34711-6501 | 2017-02-01 |
| 1295167922 | Stacy Lashunn Peterson | Counselor | 501 W Columbus St, Bakersfield, CA 93301 | 2013-08-05 |
| 1821314774 | Stacy M. Peterson | Social Worker | 405 Clement St, Suite #2, San Francisco, CA 94118-2317 | 2010-04-18 |
| 1942460563 | Stacy Peterson | Developmental Therapist | 8615 Crawford Ave, Skokie, IL 60076-2125 | 2008-06-17 |
| 1316030638 | Stacy L Peterson | Surgery | 818 N Emporia St, Suite 305, Wichita, KS 67214-3729 | 2006-09-30 |
| 1952416489 | Stacy Peterson | Emergency Medicine | 1997 Miamisburg Centerville Rd, Dayton, OH 45459-3811 | 2006-08-21 |
| Street Address |
9000 W WISCONSIN AVE |
| 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 | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720307283 | Andres Fernando Quitzon Jr. | Anesthesiology | 2245 W Brantwood Ave, Milwaukee, WI 53209 | 2010-05-24 |
| 1275500910 | Saleem Awan | Anesthesiology | 4570 S 27th St, Milwaukee, WI 53221-2145 | 2006-03-01 |
| 1871560581 | Yogendra Bharat | Anesthesiology | 2500 W Layton Ave Ste 170, Milwaukee, WI 53221-5433 | 2006-03-01 |
| 1639531650 | Braden Woodhouse Jex | Anesthesiology | 9200 W Wisconsin Ave, P348, Milwaukee, WI 53226-3522 | 2016-03-28 |
| 1851798722 | Better Health, S.c. | Anesthesiology | 7620 W Burleigh St, Milwaukee, WI 53222-5002 | 2014-11-20 |
| 1750787677 | Greater Milwaukee Health Services, S.c. | Anesthesiology | 7620 W Burleigh St, Milwaukee, WI 53222-5002 | 2014-11-05 |
| 1922397660 | Arslan Zaidi | Anesthesiology | 3305 S 20th St, Suite 100, Milwaukee, WI 53215-4940 | 2011-04-04 |
| 1235392127 | Amit Singh | Anesthesiology | 959 N Mayfair Rd, Milwaukee, WI 53226-3465 | 2008-07-09 |
| 1497821268 | Navtej S Purewal Mdsc | Anesthesiology | 3305 S 20th St, Ste 150, Milwaukee, WI 53215-4940 | 2006-11-25 |
| 1992885297 | Jeffrey Scott Quintana | Anesthesiology | 1155 N Mayfair Rd, Pain Management Clinic, Milwaukee, WI 53226-3462 | 2006-10-17 |
| Find all providers in MILWAUKEE | ||||
Please comment or provide details below to improve the information on STACY PETERSON.
| 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.