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Mattison Marie Mcwherter

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

2901 W Kinnickinnic River Pkwy Ste 102, Milwaukee, WI 53215-3660

PECOS Enrollment

This provider is enrolled in PECOS as MATTISON MCWHERTER.

Based on the most recent information from CMS, provider Mattison Marie Mcwherter is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:26 AM.

Profile Details

Provider ID
1962968412
Provider Type
Individual
Full Name
Mcwherter, Mattison Marie
Gender
Female

Sole Proprietor
No
Enumeration Date
2/20/2019
Last Updated
12/16/2024

Contact Information

Practice Location

2901 W Kinnickinnic River Pkwy Ste 102, Milwaukee, WI 53215-3660

(414) 646-8000

Unlisted Fax

Mailing Location

PO Box 735044, Chicago, IL 60673-5044

(800) 326-2250

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 8009-23 Wisconsin
Code 2255A2300X	Description Specialist/Technologist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 100296939	Description Medicaid	Issuer Unlisted Wisconsin

Mattison Marie Mcwherter

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Beres, Elise Marie

Heyrman, Jessica

Vahlsing, Olivia Josephine

Patterson, Katrina

Pittman, Jennifer Leigh

Tennant, Madeline

Smith, Jerry Wayne

Murphy, Brianna Cecelia

Howard, Rachel Deborah

Campbell, Spencer A