Organization Active NPI

Nursegenics LLC

  • Health Service Clinic/Center
  • West Allis, WI
National Provider Identifier
1205683737
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
NURSEGENICS LLC
Practice address
2363 S 102ND St Ste 202
West Allis, WI 53227-2143
Phone
(262) 417-1195
NPI assigned
May 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Miss Audryunna Tahqwela Tate, LPNNPI 1265289789
Title
Owner
Phone
(414) 982-8738

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X
Phlebotomy TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 246RP1900X
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X
Health Service Clinic/Center 261QH0100X Primary
Adult CompanionGroup: 193200000X MULTI-SPECIALTY GROUP 372600000X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X

Addresses

Primary practice location

2363 S 102ND St Ste 202
West Allis, WI 53227-2143

Mailing address

2363 S 102ND St Ste 202
West Allis, WI 53227-2143
Phone (262) 417-1195

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2307295Nursegenics LLC2363 S 102ND St, West Allis, WI 53227Certificate of waiverJul 4, 2026

National Provider Directory

National Provider Directory

Locations

2363 S 102nd St
Ste 202
West Allis, WI 53227
Phone (262) 417-1195

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1205683737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2363 S 102ND ST STE 202",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272143",
            "telephone_number": "262-417-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2363 S 102ND ST STE 202",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272143",
            "telephone_number": "262-417-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSEGENICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "AUDRYUNNA",
        "authorized_official_middle_name": "TAHQWELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-982-8738",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.