NPIMap

Organization Active NPI

General & Vascular Surgeons, S.C.

  • Vascular Surgery Physician
  • West Allis, WI
National Provider Identifier
1134211642
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
16094 Issued in WI
Legal business name
GENERAL & VASCULAR SURGEONS, S.C.
Practice address
2424 S 90TH St
Ste 208
West Allis, WI 53227-2455
Phone
(414) 328-8080
Fax
(414) 328-8084
NPI assigned
Sep 29, 2006
Last updated
Jun 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Authorized official

Name
Dr. John Wilson Bowman, M.D.NPI 1285727453
Title
Physician
Phone
(414) 328-8080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 16094 WI Primary

Addresses

Primary practice location

2424 S 90TH St
Ste 208
West Allis, WI 53227-2455

Mailing address

2424 S 90TH St
Ste 208
West Allis, WI 53227-2455
Phone (414) 328-8080

Other identifiers 1

IdentifierTypeStateIssuer
32866400MedicaidWI

National Provider Directory

National Provider Directory

Locations

2424 S 90th St
Ste 508
West Allis, WI 53227
Phone (414) 328-8080

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1134211642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "address_2": "STE 208",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8080",
            "fax_number": "414-328-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "address_2": "STE 208",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8080",
            "fax_number": "414-328-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL & VASCULAR SURGEONS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "414-328-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "16094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32866400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.