Northeast OBGYN SC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

NORTHEAST OBGYN SC

Practice address

7040 N Port Washington Rd
Suite 400
Glendale, WI 53217-3838

Phone

(414) 228-8888

Fax

(414) 228-8390

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gary P Fait, MD

Title

President

Phone

(414) 228-8888

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Barbara A Rain, MD

  • Obstetrics & Gynecology Physician
  • Meyvon, WI
  • NPI 1770513467
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1508936154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 N PORT WASHINGTON RD",
            "address_2": "SUITE 400",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532173838",
            "telephone_number": "414-228-8888",
            "fax_number": "414-228-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7040 N PORT WASHINGTON RD",
            "address_2": "SUITE 400",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532173838",
            "telephone_number": "414-228-8888",
            "fax_number": "414-228-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OBGYN SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "FAIT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-228-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31388400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Ann Nichols, OTR
• No Place Like Home Supportive Home Care Agency, LLC
• North Shore Hearing, LLC
• North Shore Orthopaedics, SC
• North Shore Psychotherapy Associates IV
• Paul E Norton, MD
• Judith Ntaba, RN
• Mervin K Ntaba
• Nuglen, LLC
• Rebecca O'Connor

• Obstetrics & Gynecology Physician in Glendale, WI
• Providers in Glendale, WI by specialty
• Obstetrics & Gynecology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.