SPINE CENTER OF WISCONSIN SC (NPI# 1467561506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467561506 |
| Entity Type | Organization |
| Organization Name | SPINE CENTER OF WISCONSIN SC |
| Practice Address |
2801 W Kinnickinnic River Pkwy Ste 355 Milwaukee WI 53215-3695 |
| Mailing Address |
Po Box 320695 Franklin WI 53132 |
| Practice Telephone | 4142353623 |
| Practice Fax Number | 4142353623 |
| Mailing Telephone | 4142353623 |
| Mailing Fax Number | 4142353623 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-09-18 |
| Authorized Official Name | MS. MARY J BANACH (OFC MGR) |
| Authorized Official Telephone | 4142353623 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
XM39276 | WI | Ambulatory Health Care Facilities |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
19042 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 30876700 | 05 |
| Street Address |
2801 W KINNICKINNIC RIVER PKWY STE 355 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53215-3695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912919002 | Stephen P Delahunt | Orthopaedic Surgery | 2801 W Kinnickinnic River Pkwy Ste 355, Milwaukee, WI 53215-3695 | 2006-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841829918 | Joshua Michael Brooks | Student in an Organized Health Care Education/Training Program | Aurora St. Lukes Medical Center 2901 W Oklahoma Ave, Milwaukee, WI 53215 | 2020-04-02 |
| 1053967091 | Kristina Strupp | Clinical Nurse Specialist | 2900 W. Oaklahoma Avenue, Milwaukee, WI 53215 | 2019-08-15 |
| 1427510296 | Madelyn Pickle | Student in an Organized Health Care Education/Training Program | 2801 W. Kinnickinnic Rd Ste 250, Milwaukee, WI 53215 | 2019-04-02 |
| 1932601838 | Elizabeth D Morawski | Nurse Practitioner | 2801 Kinnickinnic Parkway, Suite 630, Milwaukee, WI 53215 | 2018-03-06 |
| 1457872673 | Canzata Kimberly Dent | Counselor | 2727 W. Cleveland Suite 204, Milwaukee, WI 53215 | 2017-06-28 |
| 1538689955 | Christian Pena | Durable Medical Equipment & Medical Supplies | 2800 W Forest Home Ave, Suite 100, Milwaukee, WI 53215 | 2017-06-27 |
| 1386178804 | Dane A Olsen | Family Medicine | 801 W Kinnickinnic River Pkwy., Suite 250, Milwaukee, WI 53215 | 2017-04-12 |
| 1811443492 | Thomas Diamond | Physical Therapist | 2901 Kinnickinnic Parkway, Milwaukee, WI 53215 | 2016-09-01 |
| 1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
| 1992105621 | Nicole R Hall | Nurse Practitioner | 2901 S Kinnickinnic Ave, Milwaukee, WI 53215 | 2014-08-29 |
| Find all providers in zip 53215 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104222330 | Premier Cardiovascular Institute of Wisconsin LLC | Clinic/Center | 1309 S 54th St, Milwaukee, WI 53214-3404 | 2014-11-17 |
| 1265544498 | Affiliated Ent, Sc | Clinic/Center | 2500 N Mayfair Rd Ste 450, Milwaukee, WI 53226-1443 | 2006-09-01 |
| 1669911277 | Garland W. Yarborough M.d S,c | Clinic/Center | 2500 W Layton Ave, Suite250, Milwaukee, WI 53221-5420 | 2017-02-15 |
| 1801100243 | Csm Community Physician | Clinic/Center | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2010-07-27 |
| 1184805848 | Alliance Ent and Hearing Center, Sc | Clinic/Center | 201 N Mayfair Rd, Suite 515, Milwaukee, WI 53226-4216 | 2007-11-21 |
| 1538368949 | Farzad Kamrani,md.sc. | Clinic/Center | 3201 S 16th St, S# 2007, Milwaukee, WI 53215-4537 | 2007-07-16 |
| 1992713531 | Children's Hospital and Health System, Inc. | Clinic/Center | 9000 W Wisconsin Ave, Milwaukee, WI 53226-3518 | 2006-08-03 |
| 1811992233 | Blount Orthopaedic Clinic Ltd | Clinic/Center | 625 E Saint Paul Ave, Milwaukee, WI 53202-5907 | 2005-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518446558 | Northwoods Family Physical Medicine of Wisconsin, S.c. | Clinic/Center | 2360a Duck Creek Pkwy Ste 2, Green Bay, WI 54303-3377 | 2018-08-10 |
| 1629498522 | Asana Health & Wellness LLC | Clinic/Center | 2372 S Oneida St, Green Bay, WI 54304-5256 | 2014-04-18 |
| 1467792457 | Vein Care Associates S.c. | Clinic/Center | 215 Corporate Drive, Suite H, Beaver Dam, WI 53916-3124 | 2013-02-27 |
| 1447532403 | Lavender Lotus Acupuncture LLC | Clinic/Center | 130 Gregor St, Waterloo, WI 53594-1224 | 2011-09-15 |
| 1043501356 | Steven Victor Bittorf | Clinic/Center | 2505 Parkwood Dr, Green Bay, WI 54304-1956 | 2011-04-21 |
| 1881927812 | Gail A Weinand | Clinic/Center | 203 Schiek Plz, Rhinelander, WI 54501-3364 | 2009-09-09 |
| 1932368685 | Center for Stomach & Intestinal Disorders Ltd | Clinic/Center | 2300 N Mayfair Rd Ste 725, Wauwatosa, WI 53226-1533 | 2008-06-07 |
| 1568641439 | Daniel L. Gauerkei Dba Broadway Vision Center | Clinic/Center | 815 W Fulton St, Suite 103, Waupaca, WI 54981-1405 | 2007-10-29 |
| 1174723084 | Bruns Chiropractic Office Sc | Clinic/Center | 1429 North Ave, Sheboygan, WI 53083-4760 | 2007-07-19 |
| 1891919411 | Raether Chiropractic Office, S.c. | Clinic/Center | 511 E Rhine St, Elkhart Lake, WI 53020-0673 | 2007-04-13 |
| 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.