Elmbrook Pediatrics

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

ELMBROOK PEDIATRICS

Practice address

17000 W North Ave
Suite 110E
Brookfield, WI 53005-4423

Phone

(262) 786-8199

Fax

(262) 786-0769

NPI assigned

Apr 27, 2006

Organization subpart

No

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

Authorized official

Name

Nancy R. Haworth, M.D.NPI 1306803408

Title

President

Phone

(262) 786-8199

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Nancy R. Haworth, M.D.

  • Pediatric Adolescent Medicine Physician
  • Brookfield, WI
  • NPI 1306803408
  NPD (past) Authorized official
• Carl J Peluso, M.D.

  • Pediatrics Physician
  • New Berlin, WI
  • NPI 1003873548
  NPD (past)
• Mark R Staszkiewicz, M.D.

  • Pediatrics Physician
  • West Bend, WI
  • NPI 1417914524
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801853387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 W NORTH AVE",
            "address_2": "SUITE 110E",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054423",
            "telephone_number": "262-786-8199",
            "fax_number": "262-786-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 W NORTH AVE",
            "address_2": "SUITE 110E",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054423",
            "telephone_number": "262-786-8199",
            "fax_number": "262-786-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMBROOK PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAWORTH",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-786-8199",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "68180",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elmbrook Family Counseling Center LLP
• Elmbrook Family Dental Partners SC
• Elmbrook Family Dental, S.C.
• Elmbrook Internal Medicine Associates S.C.
• Elmbrook Oral & Maxillofacial Surgery Assoc., S.C.
• Josie Jean Elmer, LCSW
• Embody Health & Healing
• Emergency Room Specialists, S.C.
• Emerging Vision, Inc
• Andrea Emmerich, MSCCC-SLP

• Pediatric Adolescent Medicine Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Pediatric Adolescent Medicine 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.