BCS of Wisconsin S.C.
Organization Active NPI Psychiatry Physician · Waukesha, WI
NPI 1629579149 · NPPES record last updated Oct 3, 2024
Key facts
- NPI
- 1629579149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- BCS OF WISCONSIN S.C.
- Practice address
- 2717 N Grandview Blvd Ste 102
Waukesha, WI 53188-1672 - Phone
- (262) 513-0700
- Fax
- (262) 513-0707
- NPI assigned
- Feb 21, 2018
- Organization subpart
- No
Authorized official
- Name
- Robert Arthur Clemente
- Title
- Administrative Director
- Phone
- (248) 859-3900
Member organizations 2
Practitioners 35
-
Ijeoma Ezioma Chimezie, APNP
-
Kim Ann Heim, APNP
-
Kristen Hoskins, FNP
-
Melissa Ann Johnson, PMHNP
-
Janet Kamara, NURSE PRACTITIONER
-
Nicole C Li, FNP
-
Sabrina Pinkley, APNP, PMHNP
-
Rebecca Potts, PMHNP-BC
-
James R. Rice, APNP
-
Carol Jean Adamczyk, MSN
-
Margaret E Baker, PA-C
-
Peggy Jean Fritsch, DNP
-
Jennifer M Hayes, PA-C
-
Perry Hennessy, APNP
-
Kelty Norton, PA-C
-
Amanda Zheng, PA-C
-
Lisa Draze, APNP
-
Matthew R Herald, M.D.
-
Thomas Holbrook, MD
-
Hannah Peterson, NP
-
Jean M Volm, MSN, APNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180521002097 | WI | Part B Supplier - Clinic/Group Practice | 7618232760 |
Receives reassigned benefits from 35 practitioners Practice locations: Pewaukee, WI; Waukesha, WI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | |||
| Psychiatry Physician |
2084P0800X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Adult Health Nurse Practitioner |
363LA2200X |
Addresses
Primary practice location
2717 N Grandview Blvd Ste 102
Waukesha, WI 53188-1672
Mailing address
39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone (248) 859-3900
Other providers in Waukesha, WI
- Sandra Ann Baumgartner
- Heidi Bavlnka
- Bayer and Fahl, DDS, SC
- Bernhard Arnold Bayer
- BCS Care Solutions, LLC
- BDG of Wisconsin, Inc.
- Heather Bear
- Ellen L Beary
- Emily Gail Beaudry
- Robert J Beaumont
All providers in Waukesha, WI · Psychiatry Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.