Individual provider Active NPI

Christopher J Withers, D.O.

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1942221114
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
45668-021 Issued in WI
Practice address
2555 N Martin Luther King Dr
Milwaukee, WI 53212-2709
Phone
(414) 372-8080
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 45668-021 WI Primary

Addresses

Primary practice location

2555 N Martin Luther King Dr
Milwaukee, WI 53212-2709

Mailing address

210 W Capitol Dr
Milwaukee, WI 53212-1123
Phone (414) 372-8080

Other identifiers 2

IdentifierTypeStateIssuer
43506600MedicaidWI
P00134127OtherWIMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040615000347 WI Practitioner - Internal Medicine 2668456005 Reassigns benefits to 3 organizations
I20240812003429 AZ Practitioner - Internal Medicine 2668456005 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45668-021WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Waukesha, SC CurrentSince May 9, 2020 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Dec 20, 2009 Accepting new patients
Archwell Health Professional Services of Arizona, LLC Internal Medicine CurrentSince Jul 25, 2024 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Dec 20, 2009 Accepting new patients
Drala Telemedicine LLC Internal Medicine CurrentSince Apr 24, 2022 Accepting new patients
Outreach Community Health Centers, Inc. CurrentSince Feb 1, 2020 Accepting new patients
Outreach Community Health Centers, Inc CurrentSince Feb 1, 2020 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

4315 E Main St
Mesa, AZ 85205
Phone (480) 654-0260

1740 E Fort Lowell Rd
Ste 100
Tucson, AZ 85719
Phone (520) 613-0001

220 W Capitol Dr
Glendale, WI 53212
Phone (414) 964-9018

210 W Capitol Dr
Glendale, WI 53212

5496 N 72nd St
Milwaukee, WI 53218
Phone (414) 727-6315

1730 N 7th St
Milwaukee, WI 53205
Phone (414) 265-6360

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

4601 N 84th St
Milwaukee, WI 53225
Phone (414) 727-6315

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1942221114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121123",
            "telephone_number": "414-372-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 N MARTIN LUTHER KING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-372-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "45668-021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43506600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00134127",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.