OrganizationActive
Pai Participant 23 Sc
NPI 1528674801 · Geriatric Medicine (Internal Medicine) Physician · Shawano, WI
Provider details
- NPI number
- 1528674801
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Erin Laird, Authorized Official(410) 458-8713
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1475 Birch Hill Ln
Shawano, WI 54166-3707
Phone: (715) 526-3161
Street-level locationGet directions
Mailing address
Po Box 639676
Cincinnati, OH 45263-9676
Registry dates
- Enumerated
- 2020-09-22
- Last updated
- 2020-09-22
- Certified
- 2020-09-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.