Wisconsin Healthcare Family Practices and Behavioral Services LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

WISCONSIN HEALTHCARE FAMILY PRACTICES AND BEHAVIORAL SERVICES LLC

Practice address

10721 W Capitol Dr Ste G103
Wauwatosa, WI 53222-1210

Phone

(414) 219-9420

Fax

(414) 909-8674

NPI assigned

Sep 17, 2020

Last updated

Sep 17, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenya RobertsonNPI 1356629851

Title

FNP-BC, Pmhnp-BC

Phone

(414) 219-9420

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenya R Robertson, FNP-BC

  • Family Nurse Practitioner
  • Milwaukee, WI
  • NPI 1356629851

  Psychiatric/Mental Health

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1003422726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 W CAPITOL DR STE G103",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221210",
            "telephone_number": "414-219-9420",
            "fax_number": "414-909-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 W CAPITOL DR STE G103",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221210",
            "telephone_number": "414-219-9420",
            "fax_number": "414-909-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN HEALTHCARE FAMILY PRACTICES AND BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "KENYA",
        "authorized_official_title_or_position": "FNP-BC, PMHNP-BC",
        "authorized_official_telephone_number": "414-219-9420"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Primary Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.