Radiation Oncology of Wisconsin S C

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

RADIATION ONCOLOGY OF WISCONSIN S C

Practice address

13111 N Port Washington Rd
Attn: Radiation Oncology Dept.
Mequon, WI 53097-2416

Phone

(262) 243-8384

Fax

(920) 243-8385

NPI assigned

Feb 26, 2008

Organization subpart

No

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

Authorized official

Name

Carl E Olson, M.D.

Title

Medical Director

Phone

(414) 291-1556

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1164691986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1127",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530821127",
            "telephone_number": "920-457-6750",
            "fax_number": "920-457-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 N PORT WASHINGTON RD",
            "address_2": "ATTN: RADIATION ONCOLOGY DEPT.",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972416",
            "telephone_number": "262-243-8384",
            "fax_number": "920-243-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIATION ONCOLOGY OF WISCONSIN S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "414-291-1556",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Therapeutic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS RR MEDICARE",
            "identifier": "CJ6385",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32896900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariam Qudeimat
• Charlotte Quehl
• Connor Quill
• Cora Quirk, PHARMD
• Nicole Raczynski, NP
• Jelena Radinovic, PA-C
• Callie Jo Radovich, ATC, LAT, MSES
• Marcus Adam Radz, PHARMD
• Christina M Rahming, MSW, LCSW
• Jane Ramanujam, MD

• Radiation Oncology Physician in Mequon, WI
• Providers in Mequon, WI by specialty
• Radiation Oncology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.