Wisconsin Vein Center and Medispa, SC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

WISCONSIN VEIN CENTER AND MEDISPA, SC

Practice address

1231 George Towne Drive
Suite G
Pewaukee, WI 53072

Phone

(262) 746-9088

Fax

(262) 746-9088

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Deborah L Manjoney, MD

Title

Owner

Phone

(262) 746-9088

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Transform Diet and Wellness Center, LLC

  • Dietary Manager
  • Pewaukee, WI
  • NPI 1811249758
  NPPES parent name

Practitioners 1

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

• Jane Michalski, NP-C

  • Adult Health Nurse Practitioner
  • Pewaukee, WI
  • NPI 1386245868
  NPD

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1083732788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 GEORGE TOWNE DRIVE",
            "address_2": "SUITE G",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "53072",
            "telephone_number": "262-746-9088",
            "fax_number": "262-746-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 GEORGE TOWNE DRIVE",
            "address_2": "SUITE G",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "53072",
            "telephone_number": "262-746-9088",
            "fax_number": "262-746-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN VEIN CENTER AND MEDISPA, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "MANJONEY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-746-9088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Therese Willis, LMT
• Steve Christopher Wilsens, D.C.
• Lauren Wirth, MS, CCC-SLP
• Wisconsin CVS Pharmacy LLC
• Wisconsin Dental Group, S.C.
• Wisconsin Vision, LLC
• Lori L Wisnefski, M.D.
• Leigh Ann Wood
• Dannielle Patricia Wunderlich, DPT
• Sarah Wutke

• Vascular Surgery Physician in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Vascular Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.