Whitefish Bay Foot & Ankle Clinc, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

WHITEFISH BAY FOOT & ANKLE CLINC, LLC

Practice address

155 E Silver Spring Dr Ste 205
Whitefish Bay, WI 53217-4704

Phone

(414) 967-1900

Fax

(414) 967-1926

NPI assigned

Oct 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jason Boudreau, DPNPI 1518959378

Title

Podiatrist / Owner

Phone

(414) 967-1900

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason K. Boudreau, D.P.M.

  • Podiatrist
  • Milwaukee, WI
  • NPI 1518959378
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1003909847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11430",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532110430",
            "telephone_number": "414-962-9070",
            "fax_number": "414-962-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E SILVER SPRING DR STE 205",
            "city": "WHITEFISH BAY",
            "state": "WI",
            "postal_code": "532174704",
            "telephone_number": "414-967-1900",
            "fax_number": "414-967-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEFISH BAY FOOT & ANKLE CLINC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "BOUDREAU",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PODIATRIST / OWNER",
        "authorized_official_telephone_number": "414-967-1900",
        "authorized_official_credential": "DP"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43266800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lizhi Wei, L.AC., DIPL. AC.
• Brandon A Wells, M.S., LPC
• Elinor Rose Werner
• Trevor Wesline, DPT
• Claire Whetter, LPC
• Whitefish Bay School District
• Dawn Wilson, SLP
• Wisconsin CVS Pharmacy LLC
• Magdalena Katherine Woods, M.S., CCC-SLP

• Foot & Ankle Surgery Podiatrist in Whitefish Bay, WI
• Providers in Whitefish Bay, WI by specialty
• Foot & Ankle Surgery Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.