CH Mason Health Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CH MASON HEALTH CLINIC

Practice address

4858 W. Mother Daniels Way
Milwaukee, WI 53209

Phone

(414) 249-4613

Fax

(414) 249-4823

NPI assigned

Jan 3, 2024

Organization subpart

No

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

Authorized official

Name

Tanisha Collins-Johnson

Title

Project Manager

Phone

(414) 249-4613

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1508636358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 W MOTHER DANIELS WAY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532095311",
            "telephone_number": "414-249-4613",
            "fax_number": "414-249-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4858 W. MOTHER DANIELS WAY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-249-4613",
            "fax_number": "414-249-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CH MASON HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "COLLINS-JOHNSON",
        "authorized_official_first_name": "TANISHA",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "414-249-4613"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Cervenka
• Leah Cerwin, APSW
• Cerys Healthcare LLC
• Louis-Marcel A Cesar, M.D.
• Jolie Cetnarowski
• Kristina K. Cha-Vang, PHARMD
• Timothy Cha
• Alicia Marie Chacon, OD
• Ashish Chaddha, MD
• Daniel Steven Chadwick, PA-C

• Family Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.