Active NPI
Robert H Shedd, PA-C
- Physician Assistant
- Milwaukee, WI
National Provider Identifier
1881620110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 110-023
- Practice address
- 111 E Wisconsin Ave
Milwaukee, WI 53202-4815 - Phone
- (414) 290-6720
- Fax
- (414) 290-6755
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 110-023 | WI | Primary |
Addresses
Primary practice location
111 E Wisconsin Ave
Milwaukee, WI 53202-4815
Mailing address
111 E Wisconsin Ave
Milwaukee, WI 53202-4815
Phone (414) 290-6720
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42902100 | Medicaid | WI | |
| 970009380 | Other | WI | MEDICARE RAILROAD |
| 970027421 | Other | WI | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110-023 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc-Mercy Emergency Physicians, LLC | Physician Assistant | Past | Accepting new patients |
| Health Dynamics, LLC | Physician Assistant | Past | Accepting new patients |
| Ihc-St. Elizabeth Emergency Physicians, LLC | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Preventive Medicine/Occupational Environmental Medicine Physician
- Milwaukee, WI
- NPI 1255389581
Physician Assistant
-
- Emergency Medicine Physician
- Oshkosh, WI
- NPI 1922056753
Physician Assistant
-
- Emergency Medicine Physician
- Appleton, WI
- NPI 1851349674
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1881620110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532024815",
"telephone_number": "414-290-6720",
"fax_number": "414-290-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532024815",
"telephone_number": "414-290-6720",
"fax_number": "414-290-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEDD",
"first_name": "ROBERT",
"middle_name": "H",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "110-023",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42902100",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "970009380",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "970027421",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.