Active NPI
Lisa W Zetley, MD
- Pediatrics Physician
- Milwaukee, WI
National Provider Identifier
1225080724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 33598
- Practice address
- 1020 N 12TH St
Downtown Health Center
Milwaukee, WI 53233-1308 - Phone
- (414) 277-8900
- Fax
- (414) 277-8982
- NPI assigned
- May 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 33598 | WI | Primary |
Addresses
Primary practice location
1020 N 12TH St
Downtown Health Center
Milwaukee, WI 53233-1308
Mailing address
1020 N 12TH St
Downtown Health Center
Milwaukee, WI 53233-1308
Phone (414) 277-8900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225080724 | Medicaid | WI | |
| 002000197P | Other | HUMANA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33598 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Medical Group | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- lzetley6165@direct.chw.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361750400000",
"number": "1225080724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 N 12TH ST",
"address_2": "DOWNTOWN HEALTH CENTER",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331308",
"telephone_number": "414-277-8900",
"fax_number": "414-277-8982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 N 12TH ST",
"address_2": "DOWNTOWN HEALTH CENTER",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331308",
"telephone_number": "414-277-8900",
"fax_number": "414-277-8982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZETLEY",
"first_name": "LISA",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-16",
"last_updated": "2013-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "33598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1225080724",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "002000197P",
"state": null
}
],
"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 Feb 25, 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.