WISCONSIN NEUROLOGY CLINIC, LLC (NPI# 1639101405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639101405 |
| Entity Type | Organization |
| Organization Name | WISCONSIN NEUROLOGY CLINIC, LLC |
| Practice Address |
2603 W Rawson Ave Suite 128 Oak Creek WI 53154-8422 |
| Practice Telephone | 4144316760 |
| Practice Fax Number | 4144316761 |
| Mailing Telephone | 4144316760 |
| Mailing Fax Number | 4144316761 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-10-24 |
| Authorized Official Name | VIRENDRA K MISRA (OWNER) |
| Authorized Official Telephone | 4144316760 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
38580 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32336900 | 05 |
| Street Address |
2603 W RAWSON AVE SUITE 128 |
| City | OAK CREEK |
| State | WI |
| Zip Code | 53154-8422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437125531 | American Homepatient, Inc. | Durable Medical Equipment & Medical Supplies | 2603 W Rawson Ave, Suite 121, Oak Creek, WI 53154-8422 | 2006-02-28 |
| 1720472897 | Truecare Primary Care LLC | Family Medicine | 2603 W Rawson Ave, Suite 127, Oak Creek, WI 53154-8422 | 2015-03-26 |
| 1871916031 | Farid Ahmad | Family Medicine | 2603 W Rawson Ave, 127, Oak Creek, WI 53154-8422 | 2014-01-23 |
| 1598018459 | Dalia F. Shahwan | Nurse Practitioner | 2603 W Rawson Ave, Suite 713, Oak Creek, WI 53154-8422 | 2012-10-16 |
| 1821259227 | Margaret Bolek | Dentist | 2603 W Rawson Ave, Suite 123, Oak Creek, WI 53154-8422 | 2008-06-19 |
| 1275792830 | Carrie Lynn Zettel | Acupuncturist | 2603 W Rawson Ave, Suite 104, Oak Creek, WI 53154-8422 | 2008-06-08 |
| 1558383976 | Brian J Mcgee | Physical Therapist | 2603 W Rawson Ave, Suite 104, Oak Creek, WI 53154-8422 | 2006-07-24 |
| 1811915366 | Walter Melnyczenko | Obstetrics & Gynecology | 2603 W Rawson Ave, Oak Creek, WI 53154-8422 | 2006-07-17 |
| 1215982491 | Midwest Urgent Medical Services LLC | Clinic/Center | 2603 W Rawson Ave, Suite 113, Oak Creek, WI 53154-8422 | 2006-05-24 |
| 1780648048 | Virendra K Misra | Psychiatry & Neurology | 2603 W Rawson Ave, Suite 128, Oak Creek, WI 53154-8422 | 2006-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
| 1619512605 | Sharon Boushon | Technician | 642 E Pergola Place, Oak Creek, WI 53154 | 2019-11-13 |
| 1255991386 | Jodi Kruszka | Nurse Practitioner | 825 E Manitowoc Avenue, Oak Creek, WI 53154 | 2019-06-20 |
| 1184288896 | Thomas Carl Jonson | Durable Medical Equipment & Medical Supplies | 9036 S Carollton Dr., Oak Creek, WI 53154 | 2019-04-29 |
| 1982127577 | Zainab Saddiq | Optometrist | 8661 S. Howell Ave, 200, Oak Creek, WI 53154 | 2017-07-25 |
| 1649700980 | Froedtert & The Medical College of Wisconsin Community Physicians, Inc | Durable Medical Equipment & Medical Supplies | 7901 South 6th Street, Oak Creek, WI 53154 | 2017-06-19 |
| 1770969578 | Suhani Virparia | Pharmacist | 171 W. Town Square Way, Oak Creek, WI 53154 | 2015-08-04 |
| 1275919144 | Jessica Ford | Social Worker | 8825 South Howell Avenue, Suite 305, Oak Creek, WISCONSIN 53154 | 2015-08-03 |
| 1700269388 | Tarnit Singh Kapoor | Dentist | 8421 Howell Ave, Oak Creek, WI 53154 | 2015-07-01 |
| 1447656350 | Kiersten Kirking | Physical Therapist | 210 W. Raindbow Ridge Dr., 1207, Oak Creek, WI 53154 | 2014-11-05 |
| Find all providers in zip 53154 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780091959 | Shilpa Chaku | Psychiatry & Neurology | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2014-07-18 |
| 1780648048 | Virendra K Misra | Psychiatry & Neurology | 2603 W Rawson Ave, Suite 128, Oak Creek, WI 53154-8422 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162661 | Tseun Han James Kong | Psychiatry & Neurology | Uw Hospitals and Clinics, 600 Highland Ave, Madison, WI 53792 | 2018-04-25 |
| 1235630625 | The Cervical Spine Institute and Neuromonitoring, LLC | Psychiatry & Neurology | 2221 S Webster Ave # 268, Green Bay, WI 54301-2158 | 2018-02-22 |
| 1235647793 | Midwest Monitoring, LLC | Psychiatry & Neurology | 4321 W College Ave Ste 200, Appleton, WI 54914 | 2018-01-18 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1184011975 | Abdulrahim Ismail | Psychiatry & Neurology | 3003 University Dr Ste 203, Marinette, WI 54143-4110 | 2015-04-20 |
| 1033505821 | Heydi Flores Podadera | Psychiatry & Neurology | 721 N Midvale Blvd, Madison, WI 53705-3233 | 2015-04-08 |
| 1104221092 | Sharon Anne Bremer | Psychiatry & Neurology | 423 Landimore Ln, Wales, WI 53183-9552 | 2014-11-04 |
| 1891120093 | Robert T Schmidt Jr. | Psychiatry & Neurology | 2460 Old Plank Rd, De Pere, WI 54115-8658 | 2013-09-06 |
| 1356656771 | Klasinski Neurocare, Sc | Psychiatry & Neurology | 500 Vincent St Ste B, Stevens Point, WI 54481-1842 | 2010-08-10 |
| 1497931661 | Audrey Jantzen | Psychiatry & Neurology | 1685 Highland Ave, Department of Neurology - Centennial Building, Madison, WI 53705-2281 | 2008-01-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.