Wisconsin Pain & Rehab, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH7456 Issued in FL

Legal business name

WISCONSIN PAIN & REHAB, LLC

Practice address

2100 N Mayfair Rd
201
Wauwatosa, WI 53226-2239

Phone

(305) 608-9248

NPI assigned

Dec 19, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Todd Jason Sussman, DC

Title

Owner

Phone

(305) 608-9248

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1508135708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 ISLAND WAY",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N MAYFAIR RD",
            "address_2": "201",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262239",
            "telephone_number": "305-608-9248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN PAIN & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "SUSSMAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-608-9248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wisconsin Healthcare Family Practices and Behavioral Services LLC
• Wisconsin Heart and Vascular Clinics SC
• Wisconsin Heart Center S C
• Wisconsin Interventional Pain Solutions SC
• Wisconsin Orthopedic Physical Therapy
• Julianne Witthuhn, MS
• Jodi Roana Witty, P.T.
• Lisa M Wochos, MD
• Barry E Wolf, D.D.S.
• Sarah R Wolf, LPC, SAC-I-T

• Chiropractor in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.