NPIMap

Organization Active NPI

Children's Hospital of Wisconsin, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1952408353
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
135 Issued in WI
Legal business name
CHILDREN'S HOSPITAL OF WISCONSIN, INC.
Practice address
9000 W Wisconsin Ave
Milwaukee, WI 53226-3518
Phone
(414) 266-2000
Fax
(414) 266-6409
NPI assigned
Sep 20, 2006
Last updated
Mar 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Authorized official

Name
Mr. Marc Cadieux
Title
Corporate VP and Cfo
Phone
(414) 266-6226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 135 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Milwaukee, WI 53226-3518

Mailing address

PO Box 1997
Milwaukee, WI 53201-1997
Phone (414) 266-2000

Other identifiers 1

IdentifierTypeStateIssuer
11019700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210615000030 WI Part A Provider - End-Stage Renal Disease Facility (ESRD) 4486687399 Practice locations: Milwaukee, WI

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1506 S Oneida St
Ste 500
Appleton, WI 54915
Phone (920) 738-8050

2575 E Evergreen Dr
Appleton, WI 54913
Phone (920) 969-5353

2550 S Ashland Ave
Ste 2003
Ashwaubenon, WI 54304
Phone (920) 969-5353

12635 W Bluemound Rd
Ste 200
Brookfield, WI 53005

555 Redbird Cir
De Pere, WI 54115
Phone (920) 338-6820

W4063 Highway NN
Elkhorn, WI 53121
Phone (262) 741-1440

6809 122nd Ave
Kenosha, WI 53142
Phone (262) 654-8633

1432 W Forest Home Ave
Milwaukee, WI 53204
Phone (414) 567-5380

2561 N 29th St
Ste 101
Milwaukee, WI 53210
Phone (414) 372-4007

3365 S 103rd St
Ste 110
Milwaukee, WI 53227

3365 S 103rd St
Ste 150
Milwaukee, WI 53227

3365 S 103rd St
Ste 200
Milwaukee, WI 53227

619 W Walnut St
Ste 1059
Milwaukee, WI 53212
Phone (414) 277-8980

7201 W Good Hope Rd
Ste 300
Milwaukee, WI 53223
Phone (414) 266-7500

8800 Washington Ave
Ste 200
Mount Pleasant, WI 53406
Phone (262) 898-7970

200 Theda Clark Medical Plz
Ste 480
Neenah, WI 54956
Phone (920) 729-0608

1250 N 113th St
Ste 200
Wauwatosa, WI 53226
Phone (262) 432-6600

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1952408353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1997",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532011997",
            "telephone_number": "414-266-2000",
            "fax_number": "414-266-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263518",
            "telephone_number": "414-266-2000",
            "fax_number": "414-266-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL OF WISCONSIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "CADIEUX",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CORPORATE VP AND CFO",
        "authorized_official_telephone_number": "414-266-6226",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "WI",
            "license": "135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11019700",
            "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 Mar 29, 2016; 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.