NPIMap

Organization Active NPI

Solberg Eye Care SC

  • Preferred Provider Organization
  • Waukesha, WI
National Provider Identifier
1255510095
Registry record updated Apr 29, 2014
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Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
2334 Issued in WI
Legal business name
SOLBERG EYE CARE SC
Practice address
S30W24896 Sunset Dr
Suite 105
Waukesha, WI 53189-7021
Phone
(262) 542-5295
NPI assigned
Oct 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Authorized official

Name
Shane A Solberg
Title
Owner
Phone
(262) 542-5295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 2334 WI Primary

Addresses

Primary practice location

S30W24896 Sunset Dr
Suite 105
Waukesha, WI 53189-7021

Mailing address

S30W24896 Sunset Dr
Suite 105
Waukesha, WI 53189-7021
Phone (262) 542-5295

Other identifiers 1

IdentifierTypeStateIssuer
38587900MedicaidWI

National Provider Directory

National Provider Directory

Locations

S30W24896 Sunset Dr
Ste 105
Waukesha, WI 53189
Phone (262) 542-5295

NPI Registry JSON

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1255510095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S30W24896 SUNSET DR",
            "address_2": "SUITE 105",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897021",
            "telephone_number": "262-542-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S30W24896 SUNSET DR",
            "address_2": "SUITE 105",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897021",
            "telephone_number": "262-542-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLBERG EYE CARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "SOLBERG",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-542-5295"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WI",
            "license": "2334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38587900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.