Active NPI
Pattis Medical Services, LLC
- Family Medicine Physician
- Milwaukee, WI
National Provider Identifier
1215067665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 37017-020
- Legal business name
- PATTIS MEDICAL SERVICES, LLC
- Practice address
- 6040 W Lisbon Ave
Milwaukee, WI 53210-2116 - Phone
- (414) 447-9890
- NPI assigned
- Mar 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Susan E Pattis, M.D.
- Title
- Owner
- Phone
- (414) 447-9890
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 37017-020 | WI | Primary |
Addresses
Primary practice location
6040 W Lisbon Ave
Milwaukee, WI 53210-2116
Mailing address
6040 W Lisbon Ave
Milwaukee, WI 53210-2116
Phone (414) 447-9890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34522400 | Medicaid | WI |
National Provider Directory
National Provider DirectoryLocations
6040 W Lisbon Ave
Milwaukee, WI 53210
Phone (414) 447-9890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1226448000000",
"number": "1215067665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6040 W LISBON AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532102116",
"telephone_number": "414-447-9890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6040 W LISBON AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532102116",
"telephone_number": "414-447-9890"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PATTIS MEDICAL SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-06",
"last_updated": "2008-11-12",
"status": "A",
"authorized_official_last_name": "PATTIS",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "414-447-9890",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "WI",
"license": "37017-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34522400",
"state": "WI"
}
],
"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 Nov 12, 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.