Rachael Weiderhold D.O. Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32395 Issued in WI

Legal business name

RACHAEL WEIDERHOLD D.O. INC

Practice address

9004 W Lincoln Ave
Suite 101
West Allis, WI 53227-2452

Phone

(414) 545-5542

Fax

(414) 545-5548

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Rachael Lynn Gates, D.O.

Title

Owner

Phone

(414) 545-5542

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1215942867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9004 W LINCOLN AVE",
            "address_2": "SUITE 101",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272452",
            "telephone_number": "414-545-5542",
            "fax_number": "414-545-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9004 W LINCOLN AVE",
            "address_2": "SUITE 101",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272452",
            "telephone_number": "414-545-5542",
            "fax_number": "414-545-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACHAEL WEIDERHOLD D.O. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-545-5542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "32395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30057700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Quinnell, RN
• Quirt Family Dentistry
• Mehboob M Qureshi, MD
• R&K Support Services, Inc.
• Caitlyn Marie Raatz, CNM
• Gregory Rachu, M.D.
• Matthew David Raciti, DPT
• Kathy Jeanne Radovich, OTR
• Anthony L Ragonese, DDS
• Angela Ragozin, APNP

• Family Medicine Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.