PKM Clinical Solutions LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PKM CLINICAL SOLUTIONS LLC

Practice address

W206S7867 Pasadena Dr
Muskego, WI 53150-9532

Phone

(262) 971-5015

Fax

(855) 210-7399

NPI assigned

Oct 31, 2018

Last updated

Oct 31, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patric W Mattek, PH.D.NPI 1477540243

Title

Partner

Phone

(262) 971-5015

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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.

• Patric William Mattek, PHD

  • Psychologist
  • Oconomowoc, WI
  • NPI 1477540243
  NPD Authorized official
• Kelly M Gustavson-Mattek, PSY.D.

  • Psychologist
  • Elkhorn, WI
  • NPI 1750471314
  NPD (past)

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1295202976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W206S7867 PASADENA DR",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531509532",
            "telephone_number": "262-971-5015",
            "fax_number": "855-210-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W206S7867 PASADENA DR",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531509532",
            "telephone_number": "262-971-5015",
            "fax_number": "855-210-7399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "970 S Silver Lake St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Oconomowoc",
            "state": "WI",
            "postal_code": "530663802",
            "country_code": "US",
            "telephone_number": "262-569-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PKM CLINICAL SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "MATTEK",
        "authorized_official_first_name": "PATRIC",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "262-971-5015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1477540243",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Ann Orlando, PT
• Joon-Jae Park
• Xavier Patterson, COTA
• Lucy Pavelko
• Joy Patrice Perry, RN
• Jennifer Prem
• Mackenzie Prentice
• Presbyterian Homes of Wisconsin, Inc. (Presbyterian Homes and Services Rehabilitation)
• Progessive Physical Therapy, LLC
• Progressive Physical Therapy and Rehab Specialists

• Psychologist in Muskego, WI
• Providers in Muskego, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.