Organization Active NPI

Mission Healthcare Services LLC

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1164227401
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MISSION HEALTHCARE SERVICES LLC
Practice address
4821 N 64TH St
Milwaukee, WI 53218-4020
Phone
(262) 599-4468
NPI assigned
Feb 19, 2025
Last updated
Mar 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Reginald CephusNPI 1598214223
Title
Owner
Phone
(262) 450-5045

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
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4821 N 64TH St
Milwaukee, WI 53218-4020

Mailing address

4821 N 64TH St
Milwaukee, WI 53218-4020
Phone (262) 599-4468

Other practice location 1

5650 N Green Bay Ave
Glendale, WI 53209-4446
Phone (262) 450-5045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251106000787 WI Part B Supplier - Clinic/Group Practice 2769972926 Receives reassigned benefits from 1 practitioner
Practice locations: Milwaukee, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1164227401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 N 64TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184020",
            "telephone_number": "262-599-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4821 N 64TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184020",
            "telephone_number": "262-599-4468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5650 N Green Bay Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "WI",
            "postal_code": "532094446",
            "country_code": "US",
            "telephone_number": "262-450-5045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MISSION HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "CEPHUS",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-450-5045"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "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 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.