Mommy'S Miracle PNCC LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

MOMMY'S MIRACLE PNCC LLC

Practice address

7016 W Carmen Ave
Milwaukee, WI 53218-2218

Phone

(414) 306-2616

NPI assigned

Aug 17, 2022

Organization subpart

No

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

Authorized official

Name

Tatiana Gant

Title

Owner

Phone

(414) 306-2616

Specialties & licenses 1

Addresses

Other names 1

• Mommy's Miracle PNCC Other name

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1114645090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7016 W CARMEN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532182218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7016 W CARMEN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532182218",
            "telephone_number": "414-306-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMMY'S MIRACLE PNCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "GANT",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-306-2616"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mommy's Miracle PNCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Case Management Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Case Management Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.