Great Lakes Pain Specialists, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

GREAT LAKES PAIN SPECIALISTS, LLC

Practice address

8153 S 27TH St
Franklin, WI 53132-7012

Phone

(414) 761-1802

NPI assigned

Jul 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Staacke, M.D.NPI 1457335523

Title

Partner

Phone

(262) 787-4026

Specialties & licenses 1

Addresses

Practitioners 2

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

• Timothy S Staacke, M.D.

  • Interventional Pain Medicine Physician
  • Kenosha, WI
  • NPI 1457335523
  NPD (past) Authorized official
• Douglas Milosavljevic, M.D.

  • Interventional Pain Medicine Physician
  • Franklin, WI
  • NPI 1831173822
  NPD (past)

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1649401258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S EXECUTIVE DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054257",
            "telephone_number": "262-787-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8153 S 27TH ST",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531327012",
            "telephone_number": "414-761-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PAIN SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "STAACKE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "262-787-4026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna J Grabski, APNP
• Timothy J Grass, D.O.
• Great Lakes Anesthesia and Pain Specialists SC
• Great Lakes Foot & Ankle of Greater Milwaukee
• Great Lakes Medical LLC
• Jennifer Theresa Grimm, RPH
• Michelle L Gruenewald, R.N.
• Rita Ann Grulkowski, RN
• Gsdavis Opco-1, LLC
• Guarding Hands LLC

• Pain Medicine (Anesthesiology) Physician in Franklin, WI
• Providers in Franklin, WI by specialty
• Pain Medicine (Anesthesiology) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; 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.