GREAT LAKES PAIN SPECIALISTS, LLC (NPI# 1649401258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649401258 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES PAIN SPECIALISTS, LLC |
| Practice Address |
8153 S 27th St Franklin WI 53132-7012 |
| Mailing Address |
225 S Executive Dr Brookfield WI 53005-4257 |
| Practice Telephone | 4147611802 |
| Mailing Telephone | 2627874026 |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-07-30 |
| Authorized Official Name | DR. TIMOTHY STAACKE (PARTNER) |
| Authorized Official Telephone | 2627874026 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
8153 S 27TH ST |
| City | FRANKLIN |
| State | WI |
| Zip Code | 53132-7012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164426763 | Robert D Matteucci | Podiatrist | 8153 S 27th St, Suite 400, Franklin, WI 53132-9549 | 2005-06-10 |
| 1730689548 | Sports Physical Therapy & Rehab Specialist, S.c. | Physical Therapist | 8153 S 27th St, Franklin, WI 53132-9549 | 2018-02-19 |
| 1548679046 | Glsd Medical LLC | Clinic/Center | 8153 S 27th St, Suite 500, Franklin, WI 53132-9549 | 2014-08-08 |
| 1558674028 | Douglas Milosavljevic, M.d., S.c. | Anesthesiology | 8153 S 27th St, Suite 300, Franklin, WI 53132-9549 | 2010-07-26 |
| 1497980759 | Great Lakes Medical LLC | Clinic/Center | 8153 S 27th St, Franklin, WI 53132-7012 | 2009-05-15 |
| 1316101595 | Great Lakes Foot & Ankle of Greater Milwaukee | Clinic/Center | 8153 S 27th St, 400, Franklin, WI 53132-9549 | 2008-07-16 |
| 1831173822 | Douglas Milosavljevic | Anesthesiology | 8153 S 27th St, Suite 500, Franklin, WI 53132-9549 | 2005-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568014405 | Michelle L. Lamers, D.d.s, L.L.C. | Dentist | 7111 S 76 Street, Franklin, WI 53132 | 2019-07-11 |
| 1649833765 | Lori A Mansur | Registered Nurse | 6580 S. 46th St., Franklin, WI 53132 | 2019-04-15 |
| 1619496296 | Emily Ninnemann | Occupational Therapist | 8940 S. 51st St, Franklin, WI 53132 | 2017-09-14 |
| 1639532526 | Rinal Patel | Emergency Medicine | 9200 W Loomis Rd Ste 212, Franklin, WI 53132 | 2016-03-30 |
| 1174980098 | Lisa Obrien | Registered Nurse | 3111 W Rawson Ave Ste 210, Franklin, WI 53132 | 2016-01-22 |
| 1528446713 | Jonathan Shih | Podiatrist | 9200 W Loomis Rd Ste 116, Franklin, WI 53132 | 2015-05-08 |
| 1275940769 | Tristan Krause | Nurse Practitioner | 4225 W. Oakwood Park Court, Franklin, WI 53132 | 2014-07-16 |
| 1922344613 | Vital Imaging, LLC | Clinic/Center | 10500 W. Loomis Rd., Ste 130, Franklin, WI 53132 | 2012-12-27 |
| 1013285311 | Jill Barth | Pharmacist | 7130 South 76th Street, Franklin, WI 53132 | 2011-12-01 |
| 1235417783 | Hilary Megan Mayne | Dentist | 6855 South 27th St, Franklin, WI 53132 | 2011-08-02 |
| Find all providers in zip 53132 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598195539 | Medmd Interventional Care PC | Anesthesiology | 314 Cool Springs Blvd Ste 100, Franklin, TN 37067-6420 | 2013-11-12 |
| 1619417839 | Rinova The Wellness Group, PC | Anesthesiology | 314 Cool Springs Blvd Ste 100, Franklin, TN 37067-6420 | 2017-03-07 |
| 1962826040 | Vertex Elite Pllc | Anesthesiology | 100 Covey Dr, Suite 102, Franklin, TN 37067-5665 | 2014-02-11 |
| 1306129176 | Texessee Neuro Pllc | Anesthesiology | 100 Covey Dr, Suite 103, Franklin, TN 37067-5665 | 2011-09-27 |
| 1720218647 | Great Lakes Anesthesia and Pain Specialists Sc | Anesthesiology | 10101 S 27th St, Franklin, WI 53132-7209 | 2009-07-27 |
| 1184804403 | Premier Pain Physicians, LLC | Anesthesiology | 1 Medical Center Dr, Franklin, OH 45005-2584 | 2007-11-05 |
| 1053356857 | Middletown Anesthesia Consultants Inc | Anesthesiology | 1 Medical Center Dr, Franklin, OH 45005-2584 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700309101 | Wisconsin Interventional Pain Solutions Sc | Anesthesiology | 2500 N Mayfair Rd Ste 325, Wauwatosa, WI 53226-1443 | 2017-07-18 |
| 1528402781 | Aspen Wellness and Pain Medicine Center | Anesthesiology | W176n9830 Rivercrest Dr Ste 102, Germantown, WI 53022-4692 | 2013-04-18 |
| 1720307283 | Andres Fernando Quitzon Jr. | Anesthesiology | 2245 W Brantwood Ave, Milwaukee, WI 53209 | 2010-05-24 |
| 1861688418 | Horizon Interventional Pain Physicians, Sc | Anesthesiology | 7071 S 13th St, Suite # 102, Oak Creek, WI 53154-1466 | 2007-09-18 |
| 1992800791 | Interventional Pain Specialists of Wisconsin, Sc | Anesthesiology | 2021 Cenex Dr, Suite J, Rice Lake, WI 54868-1891 | 2006-09-14 |
| 1275500910 | Saleem Awan | Anesthesiology | 4570 S 27th St, Milwaukee, WI 53221-2145 | 2006-03-01 |
| 1871560581 | Yogendra Bharat | Anesthesiology | 2500 W Layton Ave Ste 170, Milwaukee, WI 53221-5433 | 2006-03-01 |
| 1871569830 | Roman Berezovski | Anesthesiology | 4131 W. Loomis Rd., Ste 300, Greenfield, WI 53221-2059 | 2006-02-28 |
| 1598762841 | Nathan C Meloy | Anesthesiology | 2700 W 9th Ave, Suite 205, Oshkosh, WI 54904-7247 | 2005-07-01 |
| 1922457803 | Holly Haberman | Anesthesiology | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2016-06-10 |
| 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.