Great Midwest Medical, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GREAT MIDWEST MEDICAL, INC.

Practice address

17495 W Capitol Dr
Unit K
Brookfield, WI 53045-2059

Phone

(262) 945-1094

NPI assigned

Jul 27, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Robert Donald Matteucci, D.P.M.

Title

President

Phone

(262) 945-1094

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1629356423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17495 W CAPITOL DR",
            "address_2": "UNIT K",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452059",
            "telephone_number": "262-945-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17495 W CAPITOL DR",
            "address_2": "UNIT K",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452059",
            "telephone_number": "262-945-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT MIDWEST MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "MATTEUCCI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-945-1094",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L Grams, DDS
• Natalie Grandahl, MOT
• Elliot Grant
• Jacob Gravenkamp
• Great Lakes Radiation Oncology,
• Great Midwest Pain Specialists, S.C.
• Greater Milwaukee Plastic Surgeons SC
• Debra Greeley, SLP
• Sarah Green, PSYD, LMFT
• Trelisha M Green

• Ambulatory Surgical Clinic/Center in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

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