ELMBROOK PEDIATRICS (NPI# 1801853387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801853387 |
| Entity Type | Organization |
| Organization Name | ELMBROOK PEDIATRICS |
| Practice Address |
17000 W North Ave Suite 110e Brookfield WI 53005-4423 |
| Practice Telephone | 2627868199 |
| Practice Fax Number | 2627860769 |
| Mailing Telephone | 2627868199 |
| Mailing Fax Number | 2627860769 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | NANCY R. HAWORTH (PRESIDENT) |
| Authorized Official Telephone | 2627868199 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | GROUP MEDICARE | 68180 | 01 |
| Street Address |
17000 W NORTH AVE SUITE 110E |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-4423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548263817 | Kathy I Hwang | Ophthalmology | 17000 W North Ave, Suite 100e, Brookfield, WI 53005-4423 | 2005-05-31 |
| 1487112439 | Justin Theriault | Physical Therapist | 17000 W North Ave, Brookfield, WI 53005-4423 | 2019-03-08 |
| 1295110823 | Quad Med LLC | Clinic/Center | 17000 W North Ave, Brookfield, WI 53005 | 2015-07-24 |
| 1114354453 | Claudia S Dogan-coles | Physician Assistant | 17000 W North Ave, Suite 201e, Brookfield, WI 53005-4423 | 2013-10-01 |
| 1205260411 | Jacqueline J Bergner | Nurse Practitioner | 17000 W North Ave, 104w, Brookfield, WI 53005-4423 | 2013-08-23 |
| 1669727921 | Therese G. Kerwel | Colon & Rectal Surgery | 17000 W North Ave, Suite 107w, Brookfield, WI 53005-4423 | 2012-07-23 |
| 1235437146 | Alliance Ent and Hearing Center, Sc | Clinic/Center | 17000 W North Ave, Suite 105e, Brookfield, WI 53005-4423 | 2011-03-02 |
| 1083852255 | Susan Marie Cobb | Occupational Therapist | 17000 W North Ave, Brookfield, WI 53005-4423 | 2009-01-27 |
| 1306084538 | Claudia Pedi-stealey | Physical Therapist | 17000 W North Ave, Brookfield, WI 53005-4423 | 2009-01-26 |
| 1518105949 | Barbara Kaucic Brown | Physical Therapist | 17000 W North Ave, Brookfield, WI 53005-4423 | 2009-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912929803 | Mary L. Ganz | Pediatrics | 1290 Betsy Ross Ct, Brookfield, WI 53045-5362 | 2006-07-23 |
| 1306803408 | Nancy R. Haworth | Pediatrics | 17000 W North Ave, Suite 110e, Brookfield, WI 53005-4423 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801154000 | Kathryn E Gannon-loew | Pediatrics | 540 N 16th St, Milwaukee, WI 53233-2160 | 2012-04-25 |
| 1922392067 | Mary Guillot | Pediatrics | 999 N 92nd St Ste 460, Wauwatosa, WI 53226 | 2011-06-07 |
| 1144555178 | Katsumi Neeno | Pediatrics | 2341 Tradition Ln, Janesville, WI 53545-0723 | 2009-10-08 |
| 1588857841 | Leah W Mcavoy | Pediatrics | 5471 W Waterford Ln Ste B, Appleton, WI 54913-8510 | 2007-08-21 |
| 1518165380 | Syed N Hasnain | Pediatrics | 1971 W Capitol Dr, Milwaukee, WI 53206-1909 | 2007-07-03 |
| 1629292206 | Thomas Henry Kowalski | Pediatrics | 3872 S Lake Dr Unit 404, Milwaukee, WI 53235-5236 | 2007-04-13 |
| 1164463261 | Pradeep Gopi Kumar | Pediatrics | 8348 Washington Ave, Mount Pleasant, WI 53406-3733 | 2006-06-09 |
| 1649221482 | Mary Susan Jay | Pediatrics | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2006-05-15 |
| 1962478040 | Peter S Karofsky | Pediatrics | 2711 Allen Blvd, Middleton Teen Clinic, Middleton, WI 53562 | 2006-02-27 |
| 1396740296 | Najwa A Beit Shawish | Pediatrics | 3003 W Good Hope Rd, Milwaukee, WI 53209-2042 | 2005-06-16 |
| Find all providers with the same taxonomy | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
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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.