Wisconsin Wellness Clinic

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

WISCONSIN WELLNESS CLINIC

Practice address

280 Regency CT
Suite 100
Brookfield, WI 53045-6165

Phone

(262) 373-9181

NPI assigned

May 11, 2014

Last updated

May 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa McNeil

Title

Ceo

Phone

(262) 373-9181

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1399766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399766400000",
    "number": "1891106092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 REGENCY CT",
            "address_2": "SUITE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 REGENCY CT",
            "address_2": "SUITE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456165",
            "telephone_number": "262-373-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-11",
        "last_updated": "2014-05-11",
        "status": "A",
        "authorized_official_last_name": "MCNEIL",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-373-9181"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Multi-Specialty Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2014; 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.