Breast Diagnostic Clinic SC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

BREAST DIAGNOSTIC CLINIC SC

Practice address

W238 N1645 Rockwood Drive
Ste 100
Waukesha, WI 53188-1148

Phone

(262) 523-4800

Fax

(262) 523-4805

NPI assigned

May 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John R Milbrath

Title

President

Phone

(262) 523-4800

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Richard Otto Wagner, MD

  • Diagnostic Radiology Physician
  • Edina, MN
  • NPI 1194752683
  NPD (past)

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992919278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W238 N1645 ROCKWOOD DRIVE",
            "address_2": "STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881148",
            "telephone_number": "262-523-4800",
            "fax_number": "262-523-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W238 N1645 ROCKWOOD DRIVE",
            "address_2": "STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881148",
            "telephone_number": "262-523-4800",
            "fax_number": "262-523-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAST DIAGNOSTIC CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILBRATH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-523-4800"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32691200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FDA CERTIFICATION",
            "identifier": "104257",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandeep Kaur Brar, PHARMD
• Kathleen A Brass, M.D., PHD
• Bobbie Braun
• Sheryl J Bray, R.N.
• Joan Brayer, RN
• Breathe Wellness & Prenatal Care LLC
• Cindy Maria Breber, LPN
• Michelle Elise Brehm
• Ginny Brennan
• Paul Christopher Brennan, BA

• Diagnostic Radiology Physician in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.