Wisconsin Rehabilitation Medicine Professionals, SC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

WISCONSIN REHABILITATION MEDICINE PROFESSIONALS, SC

Practice address

5200 Lakeview Ridge Rd
Belgium, WI 53004-9423

Phone

(262) 285-3888

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Sridhar V Vasudevan, M.D.

Title

President

Phone

(262) 285-3888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1871665091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1790",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530081790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 LAKEVIEW RIDGE RD",
            "city": "BELGIUM",
            "state": "WI",
            "postal_code": "530049423",
            "telephone_number": "262-285-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN REHABILITATION MEDICINE PROFESSIONALS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "VASUDEVAN",
        "authorized_official_first_name": "SRIDHAR",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-285-3888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vali Kiaie, DDS
• Karrie Knapp, LPC
• Pedro Armando Manjarrez Dominguez
• Teri E Mejchar, RN
• Deborah Ann Theis, RN

• All providers in Belgium, WI
• Physical Medicine & Rehabilitation Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.