William B. Potos M.D. Commonwealth Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14134 Issued in WI

Legal business name

WILLIAM B. POTOS M.D. COMMONWEALTH MEDICAL GROUP

Doing business as

Commonwealth Medical Group

Practice address

2500 W Layton Ave
Suite 290
Milwaukee, WI 53221-5420

Phone

(414) 281-9651

NPI assigned

Jun 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John Mutschelknaus

Title

Ceo

Phone

(414) 777-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Commonwealth Medical Group Doing business as

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1912109893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W LAYTON AVE",
            "address_2": "SUITE 290",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532215420",
            "telephone_number": "414-281-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W LAYTON AVE",
            "address_2": "SUITE 290",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532215420",
            "telephone_number": "414-281-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM B. POTOS M.D. COMMONWEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "MUTSCHELKNAUS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-777-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "14134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30862500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angelia Raychell Wilks-Tate, MS RD CD CLS
• Haley Willarson, MD
• Amanda L Willcox
• Michelle Lynn Willes, MGC, CGC
• Abbygale Mae Willging, MD
• William B. Potos M.D. Family Medicine
• William J. Saucier, M.D., S.C.
• Angela Williams, PTA
• Antoinette Williams, LPN
• Aronica V Williams, M.D.

• Family Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.