NPIMap

Organization Active NPI

Pediatrics West

  • Pediatrics Physician
  • Brookfield, WI
National Provider Identifier
1831343797
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35609-020 Issued in WI
Legal business name
PEDIATRICS WEST
Practice address
1305 N Barker Rd
Suite 1
Brookfield, WI 53045-5230
Phone
(262) 784-3200
Fax
(262) 784-8198
NPI assigned
Nov 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Authorized official

Name
Lorelle M Manion, MDNPI 1336356336
Title
MD
Phone
(262) 784-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 35609-020 WI Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 45644-020 WI

Addresses

Primary practice location

1305 N Barker Rd
Suite 1
Brookfield, WI 53045-5230

Mailing address

1305 N Barker Rd
Suite 1
Brookfield, WI 53045-5230
Phone (262) 784-3200

Other identifiers 2

IdentifierTypeStateIssuer
32207500MedicaidWI
34532400MedicaidWI

Other names 1

  • Lorelle M Manion MD, SC Other name

National Provider Directory

National Provider Directory
Tax ID family
Lorelle M Manion MD SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1305 N Barker Rd
Ste 1
Brookfield, WI 53045
Phone (262) 784-3200

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1831343797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 N BARKER RD",
            "address_2": "SUITE 1",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455230",
            "telephone_number": "262-784-3200",
            "fax_number": "262-784-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N BARKER RD",
            "address_2": "SUITE 1",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455230",
            "telephone_number": "262-784-3200",
            "fax_number": "262-784-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "MANION",
        "authorized_official_first_name": "LORELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "262-784-3200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "35609-020",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "45644-020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32207500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34532400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lorelle M Manion MD, SC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.