Great Lakes Neurosurgical Associates LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

GREAT LAKES NEUROSURGICAL ASSOCIATES LLC

Practice address

8400 Washington Ave
Racine, WI 53406-3735

Phone

(262) 884-4000

NPI assigned

Nov 13, 2007

Organization subpart

Yes

Parent organization

GREAT LAKES NEUROSURGICAL ASSOCIATES LLCAs reported in NPPES

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

Authorized official

Name

Dr. Yashdip S Pannu, M.D.

Title

Owner

Phone

(262) 321-3000

Specialties & licenses 1

Addresses

Part of

Great Lakes Nuro Assoc LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Great Lakes Neurosurgical Associates LLC

  • Neurological Surgery Physician
  • Milwaukee, WI
  • NPI 1134317738
  NPPES parent name

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1457531899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241393",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532249032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063735",
            "telephone_number": "262-884-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES NEUROSURGICAL ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT LAKES NEUROSURGICAL ASSOCIATES LLC",
        "enumeration_date": "2007-11-13",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "PANNU",
        "authorized_official_first_name": "YASHDIP",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-321-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie M Graham, HYGIENIST
• Kimberly L Granger, RNC MSN FNP
• Shakee'US Graves, APSW
• Misty Jean Gray, SAC
• Great Lakes Dermatology
• Geraldine Green, APSW
• Nyisha O Green, CNA, CMA
• Michelle Greenlee
• Gregory T Isermann DDS Ms SC
• Brittany Nickoel Griesenhofer, LMT

• Neurological Surgery Physician in Racine, WI
• Providers in Racine, WI by specialty
• Neurological Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.