Charles Grade MD, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

32662 Issued in WI

Legal business name

CHARLES GRADE MD, LLC

Practice address

7845 Harwood Ave
Wauwatosa, WI 53213-2523

Phone

(414) 270-1011

Fax

(414) 270-1031

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Charles M Grade, M.D.NPI 1790890796

Title

Psychiatrist

Phone

(414) 270-1011

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles M Grade, MD

  • Psychiatry Physician
  • Wauwatosa, WI
  • NPI 1790890796
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1922267483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7845 HARWOOD AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132523",
            "telephone_number": "414-270-1011",
            "fax_number": "414-270-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7845 HARWOOD AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132523",
            "telephone_number": "414-270-1011",
            "fax_number": "414-270-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES GRADE MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "GRADE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "414-270-1011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WI",
            "license": "32662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31874500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Demi Chae
• Rawan Chakas
• Keri Chaney, M.D.
• Kiandria Nicole Chapman, RN
• Nicole R Chapman
• Charles J. Waisbren MD S.C.
• Charles Trimberger & Associates, Inc.
• Nikolaos Chatzizacharias, MD, PHD, FRCS
• Charles William Chaveriat, RPH
• Debra Check Janisch, FNP-BC APNP

• Adult Mental Health Clinic/Center in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Adult Mental Health Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.