NPIMap

Organization Active NPI

Neurological Surgery Consultants, LTD

  • Specialist
  • Glendale, WI
National Provider Identifier
1235210907
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
24495 Issued in WI
Legal business name
NEUROLOGICAL SURGERY CONSULTANTS, LTD
Practice address
5150 N Port Washington Rd
Suite 220
Glendale, WI 53217-5474
Phone
(414) 961-0089
Fax
(414) 691-1043
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Authorized official

Name
Dr. Jack Hudson Deckard, M.D.
Title
President
Phone
(414) 961-0089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 24495 WI Primary

Addresses

Primary practice location

5150 N Port Washington Rd
Suite 220
Glendale, WI 53217-5474

Mailing address

5150 N Port Washington Rd
Suite 220
Glendale, WI 53217-5474
Phone (414) 961-0089

Other identifiers 1

IdentifierTypeStateIssuer
30464900MedicaidWI

National Provider Directory

National Provider Directory

Locations

5150 N Port Washington Rd
Ste 220
Glendale, WI 53217
Phone (414) 961-0089

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282176000000",
    "number": "1235210907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD",
            "address_2": "SUITE 220",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175474",
            "telephone_number": "414-961-0089",
            "fax_number": "414-691-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD",
            "address_2": "SUITE 220",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175474",
            "telephone_number": "414-961-0089",
            "fax_number": "414-691-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL SURGERY CONSULTANTS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-08-19",
        "status": "A",
        "authorized_official_last_name": "DECKARD",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "HUDSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-961-0089",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WI",
            "license": "24495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30464900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.