Organization Active NPI

Radiation Oncology of Wisconsin S C

  • Radiation Oncology Physician
  • Milwaukee, WI
National Provider Identifier
1740271287
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
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, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
CJ6385OtherWIRAILROAD MEDICARE
32896900MedicaidWI

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.