MEDICARE: CH MASON HEALTH CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1508636358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CH MASON HEALTH CLINIC

Provider Business Mailing Address
First Line	:	3500 W MOTHER DANIELS WAY
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-5311
Country	:	US
Telephone Number	:	414-249-4613
Fax Number	:	414-249-4823

Provider Business Practice Location Address
First Line	:	4858 W. MOTHER DANIELS WAY
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209
Country	:	US
Telephone Number	:	414-249-4613
Fax Number	:	414-249-4823

Authorized Official
Title or Position	:	PROJECT MANAGER
Name	:	TANISHA COLLINS-JOHNSON
Credential	:
Telephone Number	:	414-249-4613

Provider Enumeration Date	:	01/03/2024
Last Update Date	:	01/03/2024

Similar Medicare Providers

1093656662 — ALLISON U PICKENS
Practice Location Address:

6957 N TEUTONIA AVE APT 4
MILWAUKEE, WI
53209-2522

Practice Phone: 414-659-5684
Practice Fax:

1366384950 — JAYLUN BRYANT
Practice Location Address:

4944 NORTH 37TH ST
MILWAUKEE, WI
53209

Practice Phone: 414-391-4424
Practice Fax:

1386586980 — ALEXIS FREEMAN
Practice Location Address:

4653 N 30TH ST
MILWAUKEE, WI
53209-6015

Practice Phone: 414-982-8153
Practice Fax:

1396480158 — JASMINE WEARY
Practice Location Address:

5322 N DEXTER AVE
MILWAUKEE, WI
53209-5040

Practice Phone: 414-400-3199
Practice Fax:

1407798358 — CHRISTINA CUMAARAN M.D.
Practice Location Address:

2400 W VILLARD AVE
MILWAUKEE, WI
53209

Practice Phone: 414-527-8191
Practice Fax:

1669314340 — MRS. DESTINY C GREEN RN
Practice Location Address:

6100 N 42ND ST # 108
MILWAUKEE, WI
53209-3560

Practice Phone: 414-795-9761
Practice Fax:

1134709561 — LOVE OF GRACE ADULT SERVICES
Practice Location Address:

4556 N 41ST ST
MILWAUKEE, WI
53209-5818

Practice Phone: 262-281-1574
Practice Fax:

Directions to “CH MASON HEALTH CLINIC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.