Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 2085B0100X | Radiology | Body Imaging | 20002 | WISCONSIN | No |
| 2 | 2085B0100X | Radiology | Body Imaging | 101042 | MINNESOTA | No |
| 3 | 2085N0700X | Radiology | Neuroradiology | 20002 | WISCONSIN | No |
| 4 | 2085N0700X | Radiology | Neuroradiology | 101042 | MINNESOTA | No |
| 5 | 2085N0904X | Radiology | Nuclear Radiology | 20002 | WISCONSIN | No |
| 6 | 2085N0904X | Radiology | Nuclear Radiology | 101042 | MINNESOTA | No |
| 7 | 2085P0229X | Radiology | Pediatric Radiology | 20002 | WISCONSIN | No |
| 8 | 2085P0229X | Radiology | Pediatric Radiology | 101042 | MINNESOTA | No |
| 9 | 2085R0202X | Radiology | Diagnostic Radiology | 20002 | WISCONSIN | No |
| 10 | 2085R0202X | Radiology | Diagnostic Radiology | 101042 | MINNESOTA | No |
| 11 | 2085R0204X | Radiology | Vascular & Interventional Radiology | 20002 | WISCONSIN | No |
| 12 | 2085R0204X | Radiology | Vascular & Interventional Radiology | 101042 | MINNESOTA | No |
| 13 | 2085R0205X | Radiology | Radiological Physics | 20002 | WISCONSIN | Yes |
| 14 | 2085U0001X | Radiology | Diagnostic Ultrasound | 20002 | WISCONSIN | No |
| 15 | 2085U0001X | Radiology | Diagnostic Ultrasound | 101042 | MINNESOTA | No |
