SLEEP WELLNESS SOUTHSHORE, LLC (NPI# 1629137039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629137039 |
| Entity Type | Organization |
| Organization Name | SLEEP WELLNESS SOUTHSHORE, LLC |
| Other Organization Name | THE SLEEP WELLNESS INSTITUTE, INC |
| Practice Address |
100 15th Ave Suite 220 South Milwaukee WI 53172-1160 |
| Mailing Address |
2356 S 102nd St West Allis WI 53227-2104 |
| Practice Telephone | 4143363000 |
| Practice Fax Number | 4143361015 |
| Mailing Telephone | 4143363000 |
| Mailing Fax Number | 4143361015 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2008-02-19 |
| Authorized Official Name | VERNON R BAAKE (PARTNER) |
| Authorized Official Telephone | 4143363000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | UNITED HEALTHCARE GROUP # | 1600270 | 01 |
| WI | CIGNA SERVICE LINE PIN | 6758909 | 01 |
| WI | COMPCARE GROUP NUMBER | 391801802029 | 01 |
| WI | TRICARE GROUP NUMBER | 391801802002 | 01 |
| WI | ANTHEM BLUE CROSS GROUP # | 391801802029 | 01 |
| WI | 32890000 | 05 |
| Other Name | Type Code |
|---|---|
| The Sleep Wellness Institute, Inc | Other Name - Individual/Organization |
| Street Address |
100 15TH AVE SUITE 220 |
| City | SOUTH MILWAUKEE |
| State | WI |
| Zip Code | 53172-1160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053748160 | Lakeshore Medical Clinic | Nurse Practitioner | 100 15th Ave, South Milwaukee, WI 53172-1160 | 2013-10-03 |
| 1386081800 | Ali Hussein Alrefai | Psychiatry & Neurology | 100 15th Ave, Lakeshore Buisness Office, Attn: Gretchen Schweiss, South Milwaukee, WI 53172-1160 | 2013-05-23 |
| 1306130737 | Jothis C Jose | Family Medicine | 100 15th Ave, 180, South Milwaukee, WI 53172-1160 | 2011-06-02 |
| 1578724357 | Nadine Haddad | Family Medicine | 100 15th Ave, South Milwaukee, WI 53172-1160 | 2008-06-24 |
| 1437322559 | Michael K Shinners | Dentist | 100 15th Ave, South Milwaukee, WI 53172-1160 | 2008-04-09 |
| 1326258542 | Sabina Mccarthy | Physical Therapist | 100 15th Ave, South Milwaukee, WI 53172-1160 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952860272 | Aaron J Schricker | Counselor | 827 Milwaukee Ave, South Milwaukee, WI 53172 | 2019-03-16 |
| 1699162883 | Callie Talatzko | Registered Nurse | 1638 Minnesota Ave, South Milwaukee, WI 53172 | 2015-04-25 |
| 1043556756 | Shawna Penelope Vasquez | Occupational Therapist | 1425 Mackinac Ave, Apt # 501, South Milwaukee, WI 53172 | 2012-12-27 |
| 1376840124 | Leah Ann Schmidt | Licensed Practical Nurse | 414 Southtowne Drive, 205, South Milwaukee, WI 53172 | 2011-02-14 |
| 1619164910 | Assisted Living Concepts Inc | Assisted Living Facility | 3829 South Chicago Avenue, South Milwaukee, WI 53172 | 2007-10-01 |
| 1194844134 | Emily Ladich | Nurse Practitioner | 2901 South Chicago Avenue Ste 1, South Milwaukee, WI 53172 | 2007-03-29 |
| 1457477143 | Matthew G Bruins | Occupational Therapist | 3601 S. Chicago Avenue, South Milwaukee, WI 53172 | 2007-03-22 |
| 1134296718 | Ram K Mittal | Surgery | 100 15th Avenue, Suit 170, South Milwaukee, WI 53172 | 2006-11-29 |
| 1689915514 | Wal-mart Stores East Lp | Technician/Technologist | 222 N Chicago Ave, South Milwaukee, WI 53172 | 2013-03-01 |
| 1174799506 | School District of South Milwaukee | Local Education Agency (LEA) | 901 15th Ave, South Milwaukee, WI 53172 | 2008-05-06 |
| Find all providers in zip 53172 | ||||
| Taxonomy Code | 261QS1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Sleep Disorder Diagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437705506 | Lakeland Health Services, Inc. | Clinic/Center | 403 Stageline Rd Ste 333, Hudson, WI 54016-7848 | 2019-08-14 |
| 1093134470 | Sleep Well Home Sleep Daignostics | Clinic/Center | 130 N Wacouta Ave, Prairie Du Chien, WI 53821-1523 | 2014-04-14 |
| 1750622494 | Sleep Management Associates | Clinic/Center | 5352 N Hollywood Ave, Whitefish Bay, WI 53217-5323 | 2013-03-05 |
| 1114258704 | Sleep Resources, Inc | Clinic/Center | 1139 N 26th St, Sheboygan, WI 53081-3109 | 2010-01-20 |
| 1629288055 | Sleep Diagnostice Center LLC | Clinic/Center | 5310 W Capitol Dr Ste 215, Milwaukee, WI 53216-2263 | 2007-05-23 |
| 1225056252 | Neurotech, LLC | Clinic/Center | 626 W Moreland Blvd, Waukesha, WI 53188-2433 | 2006-07-17 |
| 1457356172 | Oxygen One, Inc. | Clinic/Center | 1900 Pewaukee Rd, Ste F, Waukesha, WI 53188-2447 | 2005-06-17 |
| 1093220246 | Sauk Prairie Healthcare Inc | Clinic/Center | 260 26th St, Prairie Du Sac, WI 53578-2203 | 2017-12-11 |
| 1578009692 | Sacred Heart Hospital of The Hospital Sisters of The 3rd Order of St F | Clinic/Center | 3802 Oakwood Mall Dr, Eau Claire, WI 54701-3016 | 2017-01-12 |
| 1528516036 | Ssm Health Care of Wisconsin Inc | Clinic/Center | 2844 Index Rd, Fitchburg, WI 53713-3117 | 2016-09-13 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH MILWAUKEE |
| Zip Code | 53172 |
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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.