Active NPI
Premise Health of Wisconsin Medical SC
- Multi-Specialty Clinic/Center
- Milwaukee, WI
National Provider Identifier
1376260646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- PREMISE HEALTH OF WISCONSIN MEDICAL SC
- Practice address
- 4400 W State St
Milwaukee, WI 53208-3140 - Phone
- (414) 931-4444
- NPI assigned
- Oct 26, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Edward William Schwartz
- Title
- President
- Phone
- (844) 407-7557
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
4400 W State St
Milwaukee, WI 53208-3140
Mailing address
5500 Maryland Way Ste 120
Brentwood, TN 37027-4993
Other names 1
- Miller Health and Fitness Center
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2272268 | Premise Health of Wisconsin Medical, SC | Certificate of waiver | Nov 16, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Premise Health of Wisconsin Medical SC
Other organizations with this tax ID 12
Organizations that report the same tax identification number in the National Provider Directory.
-
- Multi-Specialty Clinic/Center
- Schofield, WI
- NPI 1043102221
-
- Multi-Specialty Clinic/Center
- Oshkosh, WI
- NPI 1235890435
-
- Multi-Specialty Clinic/Center
- Tomahawk, WI
- NPI 1710644075
-
- Primary Care Clinic/Center
- Mineral Point, WI
- NPI 1811173313
-
- Multi-Specialty Clinic/Center
- Madison, WI
- NPI 1154074326
-
- Multi-Specialty Clinic/Center
- Franklin, WI
- NPI 1265919989
-
- Multi-Specialty Clinic/Center
- Kenosha, WI
- NPI 1760109052
-
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1912484635
-
- Multi-Specialty Clinic/Center
- Windsor, WI
- NPI 1912690439
-
- Multi-Specialty Clinic/Center
- Appleton, WI
- NPI 1922791789
-
- Multi-Specialty Clinic/Center
- Hayward, WI
- NPI 1942968953
-
- Multi-Specialty Clinic/Center
- La Crosse, WI
- NPI 1003591223
Locations
4400 W State St
Milwaukee, WI 53208
Phone (262) 928-1900
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Professional Counselor
- Kenosha, WI
- NPI 1679970123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1770163200000",
"number": "1376260646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 MARYLAND WAY STE 120",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370274993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 W STATE ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083140",
"telephone_number": "414-931-4444"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMISE HEALTH OF WISCONSIN MEDICAL SC",
"organizational_subpart": "NO",
"enumeration_date": "2022-10-26",
"last_updated": "2026-02-04",
"certification_date": "2026-02-04",
"status": "A",
"authorized_official_last_name": "SCHWARTZ",
"authorized_official_first_name": "EDWARD",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "844-407-7557"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Miller Health and Fitness Center",
"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 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.