Continence & Pelvic Wellness Clinic SC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

CONTINENCE & PELVIC WELLNESS CLINIC SC

Practice address

1516 W Mequon Rd
Suite 102
Mequon, WI 53092

Phone

(262) 240-1202

Fax

(262) 240-1205

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sherese D Hildenbrand, OTR

Title

Owner VP

Phone

(262) 240-1202

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1104848183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 W MEQUON RD",
            "address_2": "SUITE 102",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "262-240-1202",
            "fax_number": "262-240-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 W MEQUON RD",
            "address_2": "SUITE 102",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "262-240-1202",
            "fax_number": "262-240-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTINENCE & PELVIC WELLNESS CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "HILDENBRAND",
        "authorized_official_first_name": "SHERESE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER VP",
        "authorized_official_telephone_number": "262-240-1202",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41012700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.