NPIMap

Organization Active NPI

Northshore Clinic & Consultants, Inc.

  • Community/Behavioral Health Agency
  • Cedarburg, WI
National Provider Identifier
1720201163
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1695 Issued in WI
Legal business name
NORTHSHORE CLINIC & CONSULTANTS, INC.
Practice address
W62N248 Washington Ave
Suite #207
Cedarburg, WI 53012-2768
Phone
(262) 375-1116
Fax
(262) 375-1071
NPI assigned
Apr 11, 2007
Last updated
Apr 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Authorized official

Name
Therese A Jaeckle, APNP
Title
Clinical Director
Phone
(262) 375-1116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1695 WI Primary

Addresses

Primary practice location

W62N248 Washington Ave
Suite #207
Cedarburg, WI 53012-2768

Mailing address

W62N248 Washington Ave
Suite #207
Cedarburg, WI 53012-2768
Phone (262) 375-1116

National Provider Directory

National Provider Directory

Locations

W62N248 Washington Ave
Ste 207
Cedarburg, WI 53012
Phone (262) 375-1116

207 E Buffalo St
Ste 510
Milwaukee, WI 53202
Phone (262) 375-1116

2363 S 102nd St
Ste 203
West Allis, WI 53227
Phone (262) 375-1116

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1720201163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W62N248 WASHINGTON AVE",
            "address_2": "SUITE #207",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122768",
            "telephone_number": "262-375-1116",
            "fax_number": "262-375-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W62N248 WASHINGTON AVE",
            "address_2": "SUITE #207",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122768",
            "telephone_number": "262-375-1116",
            "fax_number": "262-375-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE CLINIC & CONSULTANTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "JAECKLE",
        "authorized_official_first_name": "THERESE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "262-375-1116",
        "authorized_official_credential": "APNP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "1695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.