Health and Wellness Clinic of Shorewood, S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

HEALTH AND WELLNESS CLINIC OF SHOREWOOD, S.C.

Practice address

3510 N Oakland Ave
Suite 200
Shorewood, WI 53211-2746

Phone

(414) 967-9440

Fax

(414) 967-9450

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Authorized official

Name

Zinoviya Totodova, M.D.

Title

President

Phone

(414) 967-9440

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841281367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 N OAKLAND AVE",
            "address_2": "SUITE 200",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112746",
            "telephone_number": "414-967-9440",
            "fax_number": "414-967-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH AND WELLNESS CLINIC OF SHOREWOOD, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TOTODOVA",
        "authorized_official_first_name": "ZINOVIYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-967-9440",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21280400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Graham, PHD
• Carolyn Griffin, DDS, MS
• Eva Gulotta, MS/CCC-SLP
• Tim Halverson, RDN
• Josephine Hayes-Birchler, DDS
• Healthcare Psychology Consultants LLC
• Danielle Henckel, RN
• Ryan Hermanstorfer
• Chelsea Loran Holtz, D.O
• Nancy Lee Hornby, MSW, CICSW

• Internal Medicine Physician in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Internal 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.