Team Selfkingdom

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

TEAM SELFKINGDOM

Practice address

1930 W Nash St
Milwaukee, WI 53206-2417

Phone

(312) 546-4966

NPI assigned

Jun 21, 2023

Organization subpart

No

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

Authorized official

Name

Selfkingdom Isallah

Title

Owner

Phone

(414) 671-9045

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1235814757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 N 10TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532063224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W NASH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532062417",
            "telephone_number": "312-546-4966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2852 N 10th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532063224",
            "country_code": "US",
            "telephone_number": "312-546-4966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEAM SELFKINGDOM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-21",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "ISALLAH",
        "authorized_official_first_name": "SELFKINGDOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-671-9045"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100244229",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Marie Te Ronde Manny, PHARMD
• Cheryl Teague, MS, LPC-IT
• S Teague
• Team Rehab, Inc.
• Team Rehab, Inc.
• Alisha Tearney, CCC-SLP
• Laninja Nicole Teat
• Kurt Techawatanaset, M.D.
• Technify Pro LLC
• Jerome Michael Teclaw, DDS

• Home Health Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.