Bonnie-Jo McLean Grieve, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

18939-020 Issued in WI

Practice address

W262N2442 Deer Haven Dr
Pewaukee, WI 53072-4572

Phone

(414) 510-0603

Fax

(414) 691-1911

NPI assigned

Feb 12, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1144498239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W262N2442 DEER HAVEN DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724572",
            "telephone_number": "414-510-0603",
            "fax_number": "414-691-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W262N2442 DEER HAVEN DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724572",
            "telephone_number": "414-510-0603",
            "fax_number": "414-691-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIEVE",
        "first_name": "BONNIE-JO",
        "middle_name": "MCLEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "18939-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30374000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adam C Grimm, PA
• Jolyn Gundlach, DPT
• Brittany Hablewitz, MS
• Doreen Alice Hackbarth, SLP
• Annika Claire Haley, DPT

• Pediatrics Physician in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.