Elkhorn Family Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELKHORN FAMILY CLINIC

Practice address

100 S Washington St
Elkhorn, WI 53121-1732

Phone

(262) 743-1122

Fax

(262) 743-1582

NPI assigned

May 11, 2007

Last updated

Apr 10, 2019By 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

Dr. Kamal Syed Muzaffar, MDNPI 1174599500

Title

Ceo

Phone

(262) 743-1122

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9838/brand/1/csg/1/fhir/r4

Practitioners 2

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.

• Kamal S Muzaffar, MD

  • Family Medicine Physician
  • Elkhorn, WI
  • NPI 1174599500
  Medicare reassignment NPD Authorized official
• Sandra Arens, MSN RN

  • Family Nurse Practitioner
  • Elkhorn, WI
  • NPI 1528318870
  Medicare reassignment NPD

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1164637492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S WASHINGTON ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211732",
            "telephone_number": "262-743-1122",
            "fax_number": "262-743-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S WASHINGTON ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211732",
            "telephone_number": "262-743-1122",
            "fax_number": "262-743-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHORN FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "MUZAFFAR",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_middle_name": "SYED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-743-1122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WI",
            "license": "43819-020",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34151600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Eder
• Susan Marie Egan, MSN,FNP-C
• Beth Anne Eliszewski
• Elkhorn Area School District
• Elkhorn Family Chiropractic LLC
• Elkhorn Family Dentistry LLC
• Elkhorn Pharmacy LTD
• Elkhorn Pharmacy LTD (Plaza Pharmacy)
• Elkhorn Pharmacy LTD
• Kim M Ellingham, NP

• Family Medicine Physician in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.