Individual provider Active NPI

PO Ann Cheah, PSY.D.

  • Clinical Psychologist
  • Brookfield, WI
National Provider Identifier
1992145619
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3318 Issued in WI
Practice address
13800 W North Ave
Child Development Center of CHW
Brookfield, WI 53005-4977
Phone
(262) 432-6600
Fax
(262) 432-6604
NPI assigned
Jun 26, 2013
Last updated
Nov 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X T-LMLP 2480 KS
Clinical Psychologist 103TC0700X 3318 WI Primary
Clinical Child & Adolescent Psychologist 103TC2200X 3318 WI

Addresses

Primary practice location

13800 W North Ave
Child Development Center of CHW
Brookfield, WI 53005-4977

Mailing address

13800 W North Ave
Child Development Center of CHW
Brookfield, WI 53005-4977
Phone (262) 432-6600

Other identifiers 1

IdentifierTypeStateIssuer
1992145619MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T-LMLP 2480KSMDPsychologist

Interoperability endpoints

  • Direct secure messaging: pcheah43198@direct.chw.org

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1992145619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE",
            "address_2": "CHILD DEVELOPMENT CENTER OF CHW",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054977",
            "telephone_number": "262-432-6600",
            "fax_number": "262-432-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE",
            "address_2": "CHILD DEVELOPMENT CENTER OF CHW",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054977",
            "telephone_number": "262-432-6600",
            "fax_number": "262-432-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEAH",
        "first_name": "PO ANN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "T-LMLP 2480",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3318",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WI",
            "license": "3318",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992145619",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; 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.