Sleep Wellness Southshore, LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

SLEEP WELLNESS SOUTHSHORE, LLC

Practice address

100 15TH Ave
Suite 220
South Milwaukee, WI 53172-1160

Phone

(414) 336-3000

Fax

(414) 336-1015

NPI assigned

Dec 8, 2006

Organization subpart

No

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

Authorized official

Name

Vernon R Baake

Title

Partner

Phone

(414) 336-3000

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• The Sleep Wellness Institute, Inc Other name

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Lakeshore Medical Clinic LLC

  • Durable Medical Equipment & Medical Supplies
  • Oak Creek, WI
  • NPI 1154840163

  Member Of

  NPD member
• The Sleep Wellness Institute Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • West Allis, WI
  • NPI 1528247301

  Member Of

  NPD member

Locations

Practitioners 1

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

• Masood Wasiullah, MD

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1194803692
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1629137039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 S 102ND ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272104",
            "telephone_number": "414-336-3000",
            "fax_number": "414-336-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 15TH AVE",
            "address_2": "SUITE 220",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721160",
            "telephone_number": "414-336-3000",
            "fax_number": "414-336-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP WELLNESS SOUTHSHORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "BAAKE",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "414-336-3000"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE GROUP #",
            "identifier": "1600270",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32890000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS GROUP #",
            "identifier": "391801802029",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE GROUP NUMBER",
            "identifier": "391801802002",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPCARE GROUP NUMBER",
            "identifier": "391801802029",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA SERVICE LINE PIN",
            "identifier": "6758909",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Sleep Wellness Institute, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lily Marie Shireman
• Joel Shultis
• Michael Sigala, OTR
• Kiersten Sinram
• Shenlee Sires, LPC-IT, SAC-IT
• Adam Smith, SAC-IT
• Amanda Smith
• Tamaka Tysionia Smith
• April Sorenson
• Elizabeth Sorenson, RN

• Sleep Disorder Diagnostic Clinic/Center in South Milwaukee, WI
• Providers in South Milwaukee, WI by specialty
• Sleep Disorder Diagnostic Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.