HERITAGE CLINIC S.C. (NPI# 1588736276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588736276 |
| Entity Type | Organization |
| Organization Name | HERITAGE CLINIC S.C. |
| Practice Address |
201 N Mayfair Rd Suite 535 Wauwatosa WI 53226-4216 |
| Mailing Address |
9449 N Broadmoor Rd Bayside WI 53217-1310 |
| Practice Telephone | 4147716020 |
| Practice Fax Number | 4147712242 |
| Mailing Telephone | 4147716020 |
| Mailing Fax Number | 4147712242 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RAYMOND PAUL MAGER (PRESIDENT) |
| Authorized Official Telephone | 4147716020 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 19290 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 30032400 | 05 |
| Street Address |
201 N MAYFAIR RD SUITE 535 |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53226-4216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710989090 | Anthony A Rieder | Otolaryngology | 201 N Mayfair Rd, Suite #515, Wauwatosa, WI 53226-4216 | 2005-06-01 |
| 1699374066 | Cassandra Leightner | Pharmacist | 201 N Mayfair Rd, Infusion Pharmacy - 1st Floor, Wauwatosa, WI 53226 | 2020-10-18 |
| 1518423995 | Ascension Se Wisconsin Hospital, Inc | Clinic/Center | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2019-02-11 |
| 1952872376 | Amanda Janczak | Physician Assistant | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-12-11 |
| 1780160929 | Chad Knutson | Health Educator | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-07-11 |
| 1518456938 | Elizabeth Charlene Morien | Dietetic Technician, Registered | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-05-02 |
| 1912422692 | Kayla Jankins | Physician Assistant | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2017-08-03 |
| 1093248213 | Elizabeth Arnold | Dietitian, Registered | 201 N Mayfair Rd, 2nd Fl, Wauwatosa, WI 53226-4216 | 2017-04-05 |
| 1033651062 | Alison Ward | Nurse Practitioner | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2016-11-08 |
| 1619427168 | Kathleen Ann Sinclair | Nurse Practitioner | 201 N Mayfair Rd, Suite 310, Wauwatosa, WI 53226-4216 | 2016-10-08 |
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| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376001578 | Lowtwillc | Clinic/Center | 2323 N Mayfair Rd Ste 104, Wauwatosa, WI 53226-1506 | 2019-03-06 |
| 1184958209 | Martin Men's Medical Clinic of Wisconsin | Clinic/Center | 2949 N Mayfair Rd Ste 300, Wauwatosa, WI 53222-4304 | 2009-09-22 |
| 1518167477 | West Grove Clinic, LLC | Clinic/Center | 10012 W. Capitol Dr. #101, Wauwatosa, WI 53222-1300 | 2007-07-19 |
| 1467948380 | United Lutheran Program for The Aging, Inc | Clinic/Center | 4545 N 92nd St, Wauwatosa, WI 53225-4807 | 2018-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437757986 | Wonderland Therapy LLC | Clinic/Center | 2116 Winnebago St, La Crosse, WI 54601-5060 | 2020-10-15 |
| 1124633870 | Aspirus Riverview Hospital & Clinics, Inc. | Clinic/Center | 146 N Central Ave, Marshfield, WI 54449-2173 | 2020-09-10 |
| 1952915639 | Gundersen Clinic Ltd | Clinic/Center | 2615 George St, La Crosse, WI 54603-1670 | 2020-09-01 |
| 1194337212 | Accident and Injury Rehab Center, Inc | Clinic/Center | 6114 W Capitol Dr Ste 100-102, Milwaukee, WI 53216-2147 | 2020-08-19 |
| 1275159147 | American Current Care P.a. | Clinic/Center | 6302 75th St, Kenosha, WI 53142-3506 | 2020-06-17 |
| 1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
| 1598318818 | Acorn Dietetics, LLC | Clinic/Center | 906 10th Ave, New Glarus, WI 53574-9765 | 2019-07-17 |
| 1205493582 | Freedom Family Chiropractic | Clinic/Center | 809 Phillips Blvd, Sauk City, WI 53583-1313 | 2019-05-22 |
| 1154889749 | Positive Directions Inc | Clinic/Center | 3510 W Saint Paul Ave # 6, Milwaukee, WI 53208-4125 | 2019-03-04 |
| 1144784174 | Bluestem Acupuncture | Clinic/Center | 715 Hill St Ste 130, Madison, WI 53705-3572 | 2019-01-23 |
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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.