Active NPI
Radiation Oncology of Wisconsin S C
- Radiation Oncology Physician
- Milwaukee, WI
National Provider Identifier
1740271287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- Legal business name
- RADIATION ONCOLOGY OF WISCONSIN S C
- Practice address
- 2350 N Lake Dr
Radiation Oncology Dept.
Milwaukee, WI 53211-4507 - Phone
- (414) 291-1556
- Fax
- (414) 291-1557
- NPI assigned
- Nov 3, 2005
- Last updated
- Apr 20, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donna Larue
- Title
- Office Manager
- Phone
- (920) 457-6750
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | Primary | ||
| Therapeutic Radiology Physician | 2085R0203X |
Addresses
Primary practice location
2350 N Lake Dr
Radiation Oncology Dept.
Milwaukee, WI 53211-4507
Mailing address
PO Box 1127
Sheboygan, WI 53082-1127
Phone (920) 457-6750
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CJ6385 | Other | WI | RAILROAD MEDICARE |
| 32896900 | Medicaid | WI |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208649600000",
"number": "1740271287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1127",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530821127",
"telephone_number": "920-457-6750",
"fax_number": "920-457-8350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 N LAKE DR",
"address_2": "RADIATION ONCOLOGY DEPT.",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532114507",
"telephone_number": "414-291-1556",
"fax_number": "414-291-1557"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RADIATION ONCOLOGY OF WISCONSIN S C",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-03",
"last_updated": "2008-04-20",
"status": "A",
"authorized_official_last_name": "LARUE",
"authorized_official_first_name": "DONNA",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "920-457-6750"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": null,
"license": null,
"primary": true
},
{
"code": "2085R0203X",
"taxonomy_group": "",
"desc": "Radiology, Therapeutic Radiology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CJ6385",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32896900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.