Medical Management Associates LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDICAL MANAGEMENT ASSOCIATES LLC

Practice address

2727 W Cleveland Ave
Milwaukee, WI 53215-2956

Phone

(414) 384-9880

Fax

(414) 384-0134

NPI assigned

May 2, 2008

Last updated

Oct 13, 2016By 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

Mr. Randall T Westley

Title

Owner

Phone

(414) 384-9880

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1245406982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 W CLEVELAND AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152956",
            "telephone_number": "414-384-9880",
            "fax_number": "414-384-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W CLEVELAND AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152956",
            "telephone_number": "414-384-9880",
            "fax_number": "414-384-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL MANAGEMENT ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "WESTLEY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-384-9880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32836600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.