NPIMap

Organization Active NPI

Children'S Hospital of Wisconsin

  • Pediatrics Physician
  • Green Bay, WI
National Provider Identifier
1386983930
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S HOSPITAL OF WISCONSIN
Practice address
503 S Monroe Ave
Green Bay, WI 54301-4017
Phone
(920) 436-8881
Fax
(920) 436-4413
NPI assigned
Feb 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Authorized official

Name
Weldon Gage
Title
Treasurer/Chief Financial Officer
Phone
(414) 266-6401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

503 S Monroe Ave
Green Bay, WI 54301-4017

Mailing address

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

Other names 1

  • Child Advocacy Center - Green Bay Other name

National Provider Directory

National Provider Directory
Tax ID family
Children'S Hospital of Wisconsin Inc-Fox Valley22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

503 S Monroe Ave
Green Bay, WI 54301
Phone (920) 436-8881

Practitioners & affiliated clinicians

Practitioners 2

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": "1359676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1386983930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "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": "503 S MONROE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014017",
            "telephone_number": "920-436-8881",
            "fax_number": "920-436-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL OF WISCONSIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "GAGE",
        "authorized_official_first_name": "WELDON",
        "authorized_official_title_or_position": "TREASURER/CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "414-266-6401"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child Advocacy Center - Green Bay",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.