NPIMap

Organization Active NPI

Honor on-Site Clinic

  • Medical Physician Assistant
  • Muskego, WI
National Provider Identifier
1265122022
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
HONOR ON-SITE CLINIC
Practice address
W183S8750 Racine Ave # 3
Muskego, WI 53150-8067
Phone
(262) 971-1798
Fax
(262) 679-1378
NPI assigned
May 15, 2023
Last updated
May 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Jennifer Fick, PA-CNPI 1932182177
Title
Owner/Physician Assistant
Phone
(715) 558-3510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

W183S8750 Racine Ave # 3
Muskego, WI 53150-8067

Mailing address

W179S6914 Muskego Dr
Muskego, WI 53150-9631
Phone (715) 558-3510

Other identifiers 2

IdentifierTypeStateIssuer
42946900MedicaidWI
1932182177OtherBCBS WISCONSIN

National Provider Directory

National Provider Directory
Tax ID family
Honor on-Site Clinics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1265122022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W179S6914 MUSKEGO DR",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531509631",
            "telephone_number": "715-558-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W183S8750 RACINE AVE # 3",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508067",
            "telephone_number": "262-971-1798",
            "fax_number": "262-679-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HONOR ON-SITE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-13",
        "status": "A",
        "authorized_official_last_name": "FICK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "715-558-3510",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42946900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WISCONSIN",
            "identifier": "1932182177",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskego, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.