NPIMap

Organization Active NPI

Children's Hospital of Wisconsin

Doing business as Child Advocacy Center - Lakeshore

  • Pediatrics Physician
  • Saukville, WI
National Provider Identifier
1346727443
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S HOSPITAL OF WISCONSIN
Doing business as
Child Advocacy Center - Lakeshore
Practice address
134 S Foster Dr
Saukville, WI 53080-2005
Phone
(262) 358-9080
Fax
(262) 268-2040
NPI assigned
Jul 23, 2018
Last updated
Jul 23, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDREN'S HOSPITAL OF WISCONSINAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Authorized official

Name
Sheila Reuteman
Title
Sr. Credentialing Coordinator
Phone
(414) 266-7615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

134 S Foster Dr
Saukville, WI 53080-2005

Mailing address

9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874
Phone (414) 266-7615

Other names 1

  • Child Advocacy Center - Lakeshore Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Children's Hospital of Wiscosnin Inc22 organizations share this tax ID, including this one
Part of
Children's Hospital of Wiscosnin Inc

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1346727443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 S FOSTER DR",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "530802005",
            "telephone_number": "262-358-9080",
            "fax_number": "262-268-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL OF WISCONSIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S HOSPITAL OF WISCONSIN",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "REUTEMAN",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "SR. CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "414-266-7615"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child Advocacy Center - Lakeshore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saukville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.