MID AMERICA HEALTHCARE CORP OF WISCONSIN
NPI 1477660132
Home Health in Milwaukee, WI

Q: What is Mid America Healthcare Corp Of Wisconsin's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Active since August 25, 2006CLIA 52D1008061 · Waiver

811 N HAWLEY RD, STE 201, MILWAUKEE, WI 53213(414) 578-2961(414) 578-2962 Get Directions Write a Review

NPPES record last updated: February 10, 2012. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Mid America Healthcare Corp Of Wisconsin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MID AMERICA HEALTHCARE CORP OF WISCONSIN (NPI 1477660132) is a healthcare organization registered as a home health in Milwaukee, Wisconsin and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through February 8, 2028 and lists Souphalack Khammyvong, Administrator/ Don, as its authorized official.

NPPES Registry Identity

NPI1477660132

Entity TypeOrganization

Primary Taxonomy251E00000X

Legal Business NameMID AMERICA HEALTHCARE CORP OF WISCONSIN

Location Address811 N HAWLEY RD, STE 201Milwaukee, WI 53213-3289

Mailing Address811 N Hawley RdMilwaukee, WI 53213-3289 · (414) 578-2961 · Fax (414) 578-2962

Phone(414) 578-2961

Fax(414) 578-2962

Organization SubpartNo

Authorized OfficialSouphalack KhammyvongAdministrator/ Don · (414) 578-2961

Enumeration DateAugust 25, 2006

Last NPPES UpdateFebruary 10, 2012

✔ NPI 1477660132 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies

Taxonomy Code251E00000X

License✔ Licensed in WI · 527256

Definition

A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

811 N HAWLEY RD, Milwaukee, WI 53213

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Other Identifiers 2

Medicare OSCAR/certification527256WI

Medicaid43107100WI

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D1008061

Midamerica Healthcare Corp Of Wisconsin · Milwaukee, WI

Active · expires Feb 8, 2028

CLIA Number52D1008061

Laboratory TypeHome Health Agency

Certificate Effective DateFebruary 9, 2026

Certificate Expiration DateFebruary 8, 2028

Laboratory DirectorJoan Johnson

Laboratory Phone(414) 578-2961

Laboratory LocationMidamerica Healthcare Corp Of Wisconsin811 N Hawley Rd, Milwaukee, WI 53213

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mid America Healthcare Corp Of Wisconsin's NPI number?

The NPI number for Mid America Healthcare Corp Of Wisconsin is 1477660132. It was assigned to this organization in the NPPES registry on August 25, 2006.

Where is Mid America Healthcare Corp Of Wisconsin located?

Mid America Healthcare Corp Of Wisconsin is located at 811 N Hawley Rd Ste 201, Milwaukee, WI 53213. The listed phone number is (414) 578-2961.

What is Mid America Healthcare Corp Of Wisconsin's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Mid America Healthcare Corp Of Wisconsin hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D1008061) is associated with this NPI, valid through February 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mid America Healthcare Corp Of Wisconsin was last updated on February 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.