Provider Demographics
NPI:1184791568
Name:SLEEP WELLNESS INSTITUTE, INC
Entity type:Organization
Organization Name:SLEEP WELLNESS INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:RON
Authorized Official - Last Name:BAAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-336-3000
Mailing Address - Street 1:2356 S 102ND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2104
Mailing Address - Country:US
Mailing Address - Phone:414-336-3000
Mailing Address - Fax:414-336-1015
Practice Address - Street 1:2356 S 102ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2104
Practice Address - Country:US
Practice Address - Phone:414-336-3000
Practice Address - Fax:414-336-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912981796OtherDR JACOBSON NPI
1104854363OtherNPI DR MATHAI
1144380577OtherNPI DR HARDEN
WI110004519OtherWEA GROUP NUMBER
WI6758909OtherCIGNA GROUP NUMBER
1811924343OtherNPI DR DAVOODI
WI470000838OtherRAILROAD MEDICARE GROUP #
1275694291OtherNPI DR KUMAR
WI32890000Medicaid
WI1600270OtherUNITED HEALTHCARE GROUP #
WI110004519OtherWEA GROUP NUMBER
1275694291OtherNPI DR KUMAR
WI32890000Medicaid
WI=========BOtherHUMANA GROUP NUMBER
WI470000838OtherRAILROAD MEDICARE GROUP #
WI32890000Medicaid
1255505848Medicare PIN
1144380577Medicare PIN
1912981796Medicare PIN
000092295Medicare PIN
1780820332Medicare PIN
WI6758909OtherCIGNA GROUP NUMBER
WI1600270OtherUNITED HEALTHCARE GROUP #
1275694291OtherNPI DR KUMAR
WI=========029OtherBCBS GROUP NUMBER
WI=========002OtherTRICARE GROUP NUMBER