NPIMap

Organization Active NPI

Breast Center of Central Wisconsin, S.C

  • Surgery Physician
  • Wausau, WI
National Provider Identifier
1548451230
Registry record updated Aug 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
45139 Issued in WI
Legal business name
BREAST CENTER OF CENTRAL WISCONSIN, S.C
Practice address
1506 Pine View LN
Wausau, WI 54403-2361
Phone
(715) 675-1177
NPI assigned
Aug 7, 2007
Last updated
Aug 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2011

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

Authorized official

Name
Dr. Pamela Gail Galloway, M.D.NPI 1912952318
Title
Officer
Phone
(715) 675-1177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 45139 WI Primary

Addresses

Primary practice location

1506 Pine View LN
Wausau, WI 54403-2361

Mailing address

1506 Pine View LN
Wausau, WI 54403-2361

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312675200000",
    "number": "1548451230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 PINE VIEW LN",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544032361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 PINE VIEW LN",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544032361",
            "telephone_number": "715-675-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAST CENTER OF CENTRAL WISCONSIN, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2011-08-07",
        "status": "A",
        "authorized_official_last_name": "GALLOWAY",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "715-675-1177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": "45139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.