NPIMap

Organization Active NPI

Wauwatosa Pain Management , LLC

  • Pain Clinic/Center
  • Wauwatosa, WI
National Provider Identifier
1649511304
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
WAUWATOSA PAIN MANAGEMENT , LLC
Practice address
6005 W North Ave
Wauwatosa, WI 53213-1527
Phone
(414) 530-2477
Fax
(414) 771-6311
NPI assigned
Mar 6, 2013
Last updated
Jul 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Mr. Justin Hanson
Title
Owner
Phone
(414) 530-2477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X NU Primary

Addresses

Primary practice location

6005 W North Ave
Wauwatosa, WI 53213-1527

Mailing address

6005 W North Ave
Wauwatosa, WI 53213-1527
Phone (414) 530-2477

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1649511304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532131527",
            "telephone_number": "414-530-2477",
            "fax_number": "414-771-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532131527",
            "telephone_number": "414-530-2477",
            "fax_number": "414-771-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUWATOSA PAIN MANAGEMENT , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-530-2477",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.