Holton Street Clinic, Inc.

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

License

3476800 Issued in WI

Legal business name

HOLTON STREET CLINIC, INC.

Practice address

3251 N Holton St
Milwaukee, WI 53212-2126

Phone

(414) 264-8800

Fax

(414) 264-7766

NPI assigned

May 27, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Sheila Jhansale, M.D.

Title

Medical Director

Phone

(414) 264-8800

Specialties & licenses 1

Addresses

Other names 1

• STD Specialties Clinic, Inc. Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1184882284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3251 N HOLTON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122126",
            "telephone_number": "414-264-8800",
            "fax_number": "414-264-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 N HOLTON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122126",
            "telephone_number": "414-264-8800",
            "fax_number": "414-264-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLTON STREET CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "JHANSALE",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "414-264-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "WI",
            "license": "3476800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STD Specialties Clinic, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Michael R Holt, MD
• Morgan Holt
• Andy Holtebeck, PT
• Brian James Holtebeck, PHARM.D.
• Stephanie Holter, MSW
• Christina Holton, NP
• Vicki Lynn Holton, MS, CCC-SCP
• Lauren A Holtz Pretat, PA
• Lauren Elizabeth Holub
• Meaghan Holub

• Voluntary or Charitable Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Voluntary or Charitable Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.