NPIMap

Organization Active NPI

Waukesha Family Practice Center

  • Primary Care Clinic/Center
  • Waukesha, WI
National Provider Identifier
1043344203
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WAUKESHA FAMILY PRACTICE CENTER
Practice address
210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771
Phone
(262) 548-6903
Fax
(262) 928-4075
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Ms. Chris C Purdy, RN
Title
Program Administrator
Phone
(262) 548-6916

Specialties & licenses 1

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

Addresses

Primary practice location

210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771

Mailing address

210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771
Phone (262) 548-6903

Other identifiers 1

IdentifierTypeStateIssuer
32739000MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Medical College of Wi6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

210 NW Barstow St
Ste 201
Waukesha, WI 53188
Phone (262) 548-6903

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1043344203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW ST",
            "address_2": "SUITE 201",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883771",
            "telephone_number": "262-548-6903",
            "fax_number": "262-928-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW ST",
            "address_2": "SUITE 201",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883771",
            "telephone_number": "262-548-6903",
            "fax_number": "262-928-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKESHA FAMILY PRACTICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "PURDY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "262-548-6916",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32739000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.