Richard J. Ertl, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1767-057 Issued in WI

Practice address

2266 N Prospect Ave
Suite 510
Milwaukee, WI 53202-6319

Phone

(414) 226-0137

Fax

(414) 226-0137

NPI assigned

Sep 26, 2006

Last updated

Jul 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1194826545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 N PROSPECT AVE",
            "address_2": "SUITE 510",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532026319",
            "telephone_number": "414-226-0137",
            "fax_number": "414-226-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 N PROSPECT AVE",
            "address_2": "SUITE 510",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532026319",
            "telephone_number": "414-226-0137",
            "fax_number": "414-226-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTL",
        "first_name": "RICHARD",
        "middle_name": "J.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1767-057",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1767-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39101700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "R60582",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ermed, SC
• Alexandra Ernst, MD, MPH
• Sarah Patricia Erpenbeck
• Elizabeth Nicole Erschen, NNP
• Stephanie Erstad, MS, LPC-IT, TIC
• Donna Christine Ertz, NP
• Ashley Eruchalu
• Joy Ngozi Eruchalu, RN
• David Escamilla, PHARMD
• Marloe Esch, DNP, RN, APRN-CNS

• Clinical Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.