Milwaukee Ear Nose Throat Clinic Limited

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

Legal business name

MILWAUKEE EAR NOSE THROAT CLINIC LIMITED

Practice address

10945 N Port Washington Rd Ste 211
Mequon, WI 53092-5078

Phone

(262) 241-8000

Fax

(262) 241-8096

NPI assigned

Jan 30, 2007

Last updated

Jan 7, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Joseph GoganNPI 1366434086

Title

Ceo

Phone

(262) 241-8000

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 3

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.

• Robert Joseph Gogan, MD

  • Otolaryngology Physician
  • Mequon, WI
  • NPI 1366434086
  Medicare reassignment Care Compare group Authorized official
• Anne Elizabeth Jaramillo, AU.D.

  • Audiologist
  • Mequon, WI
  • NPI 1184870529
  Medicare reassignment Care Compare group
• Sheila M Chamberlin, MS CCC A

  • Audiologist
  • Milwaukee, WI
  • NPI 1902839178
  Medicare reassignment

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1457497091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD",
            "address_2": "SUITE 211",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925078",
            "telephone_number": "262-241-8000",
            "fax_number": "262-241-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD STE 211",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925078",
            "telephone_number": "262-241-8000",
            "fax_number": "262-241-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKEE EAR NOSE THROAT CLINIC LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "GOGAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-241-8000"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30326800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "C01734",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Weber Miller, PT
• Lisa Ann Miller
• Taylor Jean Miller
• Milwaukee Center for Diagnostic Imaging LLC (Center for Diagnostic Imaging)
• Milwaukee Counseling Center LLC
• Milwaukee ENT Speech & Hearing Aid Service
• Milwaukee Hand Center S C (The Milwaukee Hand Center)
• Milwaukee Hearing Center LLC
• Milwaukee Orthopaedic Group LTD
• Milwaukee Recovery Associates LLC

• Facial Plastic Surgery Physician in Mequon, WI
• Providers in Mequon, WI by specialty
• Facial Plastic Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.