Wisconsin Pain Management Specialists, LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

53681-20 Issued in WI

Legal business name

WISCONSIN PAIN MANAGEMENT SPECIALISTS, LLC

Practice address

1050 S. Milwaukee Avenue
Suite 102
Burlington, WI 53105

Phone

(262) 758-6155

NPI assigned

Jul 9, 2018

Last updated

Jul 24, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael W Jung, MD

Title

Ceo

Phone

(262) 412-6799

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1720574288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 135",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530290135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 S. MILWAUKEE AVENUE",
            "address_2": "SUITE 102",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "53105",
            "telephone_number": "262-758-6155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W Layton Ave Ste 170",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532215433",
            "country_code": "US",
            "telephone_number": "414-281-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WISCONSIN PAIN MANAGEMENT SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-09",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-412-6799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "WI",
            "license": "53681-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208VP0000X",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Williams
• Erin E Williams, PSY.D.
• Karen Ann Willich, LPN
• Danielle Winchell, M.A.O.M, LAC
• Angela Wingo
• Wisconsin Pain Management, S.C.
• Wisconsin Pain Management, S.C.
• Wisconsin Psychology Associates, LLC
• Wisconsin Psychology Associates, LLC
• Wisconsin Vision Associates

• Pain Medicine Physician in Burlington, WI
• Providers in Burlington, WI by specialty
• Pain Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.