NPIMap

Organization Active NPI

Milwaukee Medical Weight Loss & Medispa, Inc.

  • Nurse Practitioner
  • Greenfield, WI
National Provider Identifier
1659747194
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6307-33 Issued in WI
Legal business name
MILWAUKEE MEDICAL WEIGHT LOSS & MEDISPA, INC.
Practice address
8575 W Forest Home Ave
Suite 170
Greenfield, WI 53228-3469
Phone
(414) 616-3535
Fax
(414) 427-6338
NPI assigned
Aug 19, 2015
Last updated
Aug 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Authorized official

Name
Sandeep Ramanujam, M.D.
Title
Medical Director
Phone
(414) 616-3535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6307-33 WI Primary

Addresses

Primary practice location

8575 W Forest Home Ave
Suite 170
Greenfield, WI 53228-3469

Mailing address

8575 W Forest Home Ave
Suite 170
Greenfield, WI 53228-3469
Phone (414) 616-3535

National Provider Directory

National Provider Directory

Locations

8575 W Forest Home Ave
Ste 170
Greenfield, WI 53228
Phone (414) 616-3535

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": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1659747194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 W FOREST HOME AVE",
            "address_2": "SUITE 170",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283469",
            "telephone_number": "414-616-3535",
            "fax_number": "414-427-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 W FOREST HOME AVE",
            "address_2": "SUITE 170",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283469",
            "telephone_number": "414-616-3535",
            "fax_number": "414-427-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKEE MEDICAL WEIGHT LOSS & MEDISPA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "RAMANUJAM",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "414-616-3535",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6307-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.