City of South Milwaukee

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

CITY OF SOUTH MILWAUKEE

Doing business as

South Milwaukee Health Department

Practice address

2424 15TH Ave
South Milwaukee, WI 53172-2410

Phone

(414) 768-8055

Fax

(414) 768-5720

NPI assigned

Jun 4, 2007

Organization subpart

Yes

Parent organization

CITY OF SOUTH MILWAUKEEAs reported in NPPES

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

Authorized official

Name

Jacqueline Marie Ove, R.N.

Title

Public Health Administrator

Phone

(414) 768-8055

Specialties & licenses 2

Addresses

Other names 1

• South Milwaukee Health Department Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• City of South Milwaukee

  • Land Ambulance
  • South Milwaukee, WI
  • NPI 1053401018

  3375517238

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

City of South Milwaukee2 organizations share this tax ID, including this one

Part of

City of South Milwaukee

Other organizations with this tax ID 1

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

• City of South Milwaukee

  • Land Ambulance
  • South Milwaukee, WI
  • NPI 1053401018
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• City of South Milwaukee

  • Land Ambulance
  • South Milwaukee, WI
  • NPI 1053401018
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Kosterman, NP

  • Family Nurse Practitioner
  • South Milwaukee, WI
  • NPI 1386408599
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1871795690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 15TH AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722410",
            "telephone_number": "414-768-8055",
            "fax_number": "414-768-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 15TH AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722410",
            "telephone_number": "414-768-8055",
            "fax_number": "414-768-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SOUTH MILWAUKEE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY OF SOUTH MILWAUKEE",
        "enumeration_date": "2007-06-04",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "OVE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PUBLIC HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "414-768-8055",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Milwaukee Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Milwaukee Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Center for Self
• Tou Chang
• George D. Cherayil, M.D.
• Kayla Khanh Chu
• City of South Milwaukee
• Megan Mae Clement, PHARMD
• Cheron Copeland, NDTR
• Dana Correnti, PA-C
• Michael L Costello, DDS
• Shauntee Marie Crawford

• State or Local Public Health Clinic/Center in South Milwaukee, WI
• Providers in South Milwaukee, WI by specialty
• State or Local Public Health Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.