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CH MASON HEALTH CLINIC
NPI 1508636358
Family Medicine in Milwaukee, WI

Active since January 03, 2024CLIA 52D2105520 · Waiver
4858 W. MOTHER DANIELS WAY, MILWAUKEE, WI 53209(414) 249-4613(414) 249-4823 Get Directions Write a Review

NPPES record last updated: January 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ch Mason Health Clinic NPPES

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

CH MASON HEALTH CLINIC (NPI 1508636358) is a healthcare organization registered as a family medicine in Milwaukee, Wisconsin and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through January 31, 2027 and lists Tanisha Collins-johnson, Project Manager, as its authorized official.

NPPES Registry Identity

NPI1508636358
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCH MASON HEALTH CLINIC
Location Address4858 W. MOTHER DANIELS WAYMilwaukee, WI 53209
Mailing Address3500 W Mother Daniels WayMilwaukee, WI 53209-5311 · (414) 249-4613 · Fax (414) 249-4823
Phone(414) 249-4613
Fax(414) 249-4823
Organization SubpartNo
Authorized OfficialTanisha Collins-johnsonProject Manager · (414) 249-4613
Enumeration DateJanuary 3, 2024
NPPES CertifiedDecember 29, 2023
✔ NPI 1508636358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4858 W. MOTHER DANIELS WAY, Milwaukee, WI 53209
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 52D2105520

Ch Mason Clinic LLC · Milwaukee, WI
Active · expires Jan 31, 2027
CLIA Number52D2105520
Laboratory TypePhysician Office
Certificate Effective DateFebruary 1, 2025
Certificate Expiration DateJanuary 31, 2027
Laboratory DirectorDr. Kemba M. Banyard
Laboratory Phone(262) 977-7771
Laboratory LocationCh Mason Clinic LLC4858 West Mother Daniels Way, Milwaukee, WI 53209
CLIA data matches this NPI record on: Address
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 Ch Mason Health Clinic's NPI number?

The NPI number for Ch Mason Health Clinic is 1508636358. It was assigned to this organization in the NPPES registry on January 3, 2024.

Where is Ch Mason Health Clinic located?

Ch Mason Health Clinic is located at 4858 W. Mother Daniels Way, Milwaukee, WI 53209. The listed phone number is (414) 249-4613.

What is Ch Mason Health Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Ch Mason Health Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2105520) is associated with this NPI, valid through January 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ch Mason Health Clinic was last updated on January 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.