East Town Professional Associates, S.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

EAST TOWN PROFESSIONAL ASSOCIATES, S.C.

Practice address

1017 W Glen Oaks LN
Suite 201
Mequon, WI 53092-3371

Phone

(262) 241-3698

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Christina C Keppel, MD

Title

President

Phone

(262) 241-3698

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Patricia Ann Flanagan, PHD

  • Clinical Psychologist
  • Mequon, WI
  • NPI 1508943366
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669411567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W GLEN OAKS LN",
            "address_2": "SUITE 201",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923371",
            "telephone_number": "262-241-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W GLEN OAKS LN",
            "address_2": "SUITE 201",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923371",
            "telephone_number": "262-241-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TOWN PROFESSIONAL ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEPPEL",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-241-3698",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42236200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista M Dyreson, M.D.
• Drew David Dyrssen, LPC
• Dysphagia Testing, LLC
• Ease Chiropractic LLC
• East Mequon Surgery Center LLC
• East Towne Dental Associated Belgium Family Dental SC
• Thomas L Eaton, MD
• Halie Ecker, MS, LPC, SAC, PMH-C
• Isabella Eckert
• Julie L Educate, LPC

• Psychiatry Physician in Mequon, WI
• Providers in Mequon, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.