Organization Active NPI

Milwaukee Spinal Specialists, S.C.

  • Orthopaedic Surgery of the Spine Physician
  • Milwaukee, WI
National Provider Identifier
1124359880
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
25408 Issued in WI
Legal business name
MILWAUKEE SPINAL SPECIALISTS, S.C.
Practice address
575 W. River Woods Pkwy
Suite 305
Milwaukee, WI 53212-1003
Phone
(414) 961-2225
Fax
(414) 961-0298
NPI assigned
Jan 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Authorized official

Name
Kiki Misovy
Title
Accounts Rep
Phone
(414) 961-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X 25408 WI Primary

Addresses

Primary practice location

575 W. River Woods Pkwy
Suite 305
Milwaukee, WI 53212-1003

Mailing address

575 W. River Woods Pkwy
Suite 305
Milwaukee, WI 53212-1003
Phone (414) 961-2225

National Provider Directory

National Provider Directory

Locations

575 W River Woods Pkwy
Ste 305
Glendale, WI 53212
Phone (414) 961-2225

13111 N Port Washington Rd
Ste 110
Mequon, WI 53097
Phone (262) 243-9172

2015 E Newport Ave
#805
Milwaukee, WI 53211
Phone (414) 961-2225

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1124359880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 W. RIVER WOODS PKWY",
            "address_2": "SUITE 305",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121003",
            "telephone_number": "414-961-2225",
            "fax_number": "414-961-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 W. RIVER WOODS PKWY",
            "address_2": "SUITE 305",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121003",
            "telephone_number": "414-961-2225",
            "fax_number": "414-961-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKEE SPINAL SPECIALISTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "MISOVY",
        "authorized_official_first_name": "KIKI",
        "authorized_official_title_or_position": "ACCOUNTS REP",
        "authorized_official_telephone_number": "414-961-2225"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "WI",
            "license": "25408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.