Shorewood Family Physicians S C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHOREWOOD FAMILY PHYSICIANS S C

Practice address

1901 E Capitol Dr
Shorewood, WI 53211-2335

Phone

(414) 962-7477

Fax

(414) 962-2420

NPI assigned

Jun 3, 2006

Last updated

Aug 22, 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

Jacqueline A Petruzates

Title

Office Manager

Phone

(414) 962-7477

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528006277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E CAPITOL DR",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112335",
            "telephone_number": "414-962-7477",
            "fax_number": "414-962-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 E CAPITOL DR",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112335",
            "telephone_number": "414-962-7477",
            "fax_number": "414-962-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOREWOOD FAMILY PHYSICIANS S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETRUZATES",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "414-962-7477"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah K Schermer, MS, CCC-SLP
• Mazen Seddick, RPH
• Judith Y Selby, RN
• Stephen Michael Sherman, D.C.
• Shorewood Family Dentistry, LLC
• Shorewood Health Department
• Shorewood School District
• Shorewood Specialty LLC (Sage Specialty Pharmacy)
• Andrew M Silverman, LCSW
• Sunae Son, L.AC

• Family Medicine Physician in Shorewood, WI
• Providers in Shorewood, 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 Aug 22, 2020; 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.