NPIMap

Organization Active NPI

Benjamin S Gozon MD SC

  • Rehabilitation Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1346378510
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
42976 Issued in WI
Legal business name
BENJAMIN S GOZON MD SC
Doing business as
Capitol Rehabilitation Clinic
Practice address
8518 W Capitol Dr
Milwaukee, WI 53222-1827
Phone
(414) 464-4888
Fax
(414) 464-1850
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Authorized official

Name
Dr. Benjamin S Gozon III, M.D.NPI 1033170428
Title
President
Phone
(414) 464-4888

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
Rehabilitation Clinic/Center 261QR0400X 42976 WI Primary

Addresses

Primary practice location

8518 W Capitol Dr
Milwaukee, WI 53222-1827

Mailing address

8518 W Capitol Dr
Milwaukee, WI 53222-1827
Phone (414) 464-4888

Other identifiers 1

IdentifierTypeStateIssuer
34058300MedicaidWI

Other names 1

  • Capitol Rehabilitation Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

8518 W Capitol Dr
Milwaukee, WI 53222
Phone (414) 305-4350

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298505600000",
    "number": "1346378510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8518 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221827",
            "telephone_number": "414-464-4888",
            "fax_number": "414-464-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8518 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221827",
            "telephone_number": "414-464-4888",
            "fax_number": "414-464-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN S GOZON MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-02-24",
        "status": "A",
        "authorized_official_last_name": "GOZON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-464-4888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "WI",
            "license": "42976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34058300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capitol Rehabilitation Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 24, 2011; 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.