Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1326433301 Individual Practitioner Female Practitioner

Dr. Katie Anne Willcockson , MD

Pediatrics • New Berlin, WI

Professional Overview & Biography Verified Profile Summary

Dr. Katie Willcockson, MD is a registered healthcare professional specializing in Pediatrics in New Berlin, WI. Practice services are available at 4855 S MOORLAND RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4855 S Moorland Rd

New Berlin, WI 531517494

Telephone 2624327599
Fax 2624327694
Associated Practice Facility / Clinic
🏢 Children's Medical Group Facility NPI 1427223767

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in New Berlin, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.0 Yrs
State Avg: 18.1 Yrs
Regional Practice Density
67 Specialists

Practicing in New Berlin, WI (1245 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-07-21
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WI 75410-20

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License UT 10100590-1205

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1326433301 (WI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003873548

Doctor of Medicine (M.D.)

Andrea Fox , APRN

Nurse Practitioner - Pediatrics

NPI 1013245208

Advanced Practice Registered Nurse

Katherine Waller , APNP

Nurse Practitioner - Pediatrics

NPI 1013525096

Advanced Practice Nurse Prescriber

Hannah Mazur

Nurse Practitioner - Family

NPI 1063394807
NPI 1063727642

Doctor of Medicine (M.D.)

NPI 1073878419

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location July 21, 2021

Registered at 4855 S MOORLAND RD, NEW BERLIN, WI 531517494 (Tel: 2624327599)

📍
Updated Business Mailing Address July 21, 2021

Registered at 9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 532264874 (Tel: 4142667615)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2021

Pediatrics (License #75410-20 in WI)

👤
Provider Name / Credentials Updated April 02, 2018

Recorded as KATIE WILLCOCKSON, M.D.

NPI Profile Active October 07, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location October 07, 2016

Registered at 100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 841131103 (Tel: 8015877400)

📍
Updated Business Mailing Address October 07, 2016

Registered at 295 S CHIPETA WAY, SALT LAKE CITY, UT 841081287 (Tel: 8015877400)

👤
Provider Name / Credentials Updated October 07, 2016

Recorded as KATIE KENEALY, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 07, 2016

Pediatrics (License #10100590-1205 in UT)

🟢
Initial NPI Registration & Enumeration April 06, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1326433301
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 06, 2015
Last Update: July 21, 2021
Sole Proprietor: Yes

Mailing Address

9000 W Wisconsin Ave # Ms 958

Milwaukee, WI 532264874

Phone: 4142667615

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.