NPIMap

Organization Active NPI

Physician Associates of Wisconsin, SC

  • Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1437472172
Registry record updated Mar 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
904-023 Issued in WI
Legal business name
PHYSICIAN ASSOCIATES OF WISCONSIN, SC
Practice address
7033 Wellauer Dr
Milwaukee, WI 53213-3734
Phone
(414) 727-5467
Fax
(206) 222-2918
NPI assigned
Mar 9, 2010
Last updated
Mar 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2010

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

Authorized official

Name
Dr. Jeffrey Gerard Nicholson, PHD, PA-CNPI 1326018904
Title
Clinic Manager
Phone
(414) 727-5467

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 904-023 WI Primary
Clinic/Center 261Q00000X 11224-20 WI

Addresses

Primary practice location

7033 Wellauer Dr
Milwaukee, WI 53213-3734

Mailing address

7033 Wellauer Dr
Milwaukee, WI 53213-3734
Phone (414) 727-5467

National Provider Directory

National Provider Directory

Locations

5032 W Forest Home Ave
Ste 4
Milwaukee, WI 53219
Phone (414) 877-1700

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1437472172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 WELLAUER DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532133734",
            "telephone_number": "414-727-5467",
            "fax_number": "206-222-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7033 WELLAUER DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532133734",
            "telephone_number": "414-727-5467",
            "fax_number": "206-222-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ASSOCIATES OF WISCONSIN, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "414-727-5467",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, PA-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "904-023",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "11224-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 9, 2010; 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.