NPIMap

Organization Active NPI

Gerald G. Govin, MD,SC

  • Specialist
  • Brookfield, WI
National Provider Identifier
1336333137
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21950 Issued in WI
Legal business name
GERALD G. GOVIN, MD,SC
Practice address
16535 W Bluemound Rd
Suite 222
Brookfield, WI 53005-5936
Phone
(262) 786-3222
NPI assigned
Sep 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Dr. Gerald G. Govin, M.D.
Title
Medical Doctor /Owner
Phone
(262) 786-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 21950 WI Primary

Addresses

Primary practice location

16535 W Bluemound Rd
Suite 222
Brookfield, WI 53005-5936

Mailing address

16535 W Bluemound Rd
Suite 222
Brookfield, WI 53005-5936
Phone (262) 786-3222

Other identifiers 1

IdentifierTypeStateIssuer
30529700MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1336333137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16535 W BLUEMOUND RD",
            "address_2": "SUITE 222",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055936",
            "telephone_number": "262-786-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16535 W BLUEMOUND RD",
            "address_2": "SUITE 222",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055936",
            "telephone_number": "262-786-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD G. GOVIN, MD,SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "GOVIN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MEDICAL DOCTOR /OWNER",
        "authorized_official_telephone_number": "262-786-3222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WI",
            "license": "21950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30529700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.