NPIMap

Organization Active NPI

Carbon Health Primary Care of Wisconsin SC

  • Urgent Care Clinic/Center
  • Wauwatosa, WI
National Provider Identifier
1033820386
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CARBON HEALTH PRIMARY CARE OF WISCONSIN SC
Practice address
11415 W Burleigh St Ste 103
Wauwatosa, WI 53222-3217
Phone
(415) 446-1733
NPI assigned
Dec 7, 2022
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Kaitlin Boyle
Title
Director
Phone
(303) 601-5392

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

11415 W Burleigh St Ste 103
Wauwatosa, WI 53222-3217

Mailing address

2100 Franklin St Ste 355
Oakland, CA 94612-3140

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1033820386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 FRANKLIN ST STE 355",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11415 W BURLEIGH ST STE 103",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532223217",
            "telephone_number": "415-446-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBON HEALTH PRIMARY CARE OF WISCONSIN SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-07",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "KAITLIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-601-5392"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.