Coast to Coast Wisconsin LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

COAST TO COAST WISCONSIN LLC

Practice address

410 Dewey St
Wisconsin Rapids, WI 54494-4715

Phone

(715) 423-6060

NPI assigned

Feb 26, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Mark Bolton, MDNPI 1790785152

Title

Ceo

Phone

(614) 855-9961

Specialties & licenses 1

Addresses

Practitioners 5

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

• Mark James Bolton, M.D.

  • General Practice Physician
  • Columbus, OH
  • NPI 1790785152

  Emergency Medicine

  NPD Authorized official
• Gregory F Broyles, PA-C

  • Physician Assistant
  • Wisconsin Rapids, WI
  • NPI 1841223427
  NPD (past)
• Jac A Clement, PA-C

  • Physician Assistant
  • Oconto, WI
  • NPI 1649289778
  NPD (past)
• Michael G Conard, PA

  • Physician Assistant
  • Neillsville, WI
  • NPI 1538144001
  NPD (past)
• Frederick D Kosmach, PA-C

  • Physician Assistant
  • Minong, WI
  • NPI 1760487722
  NPD (past)

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1255723375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5195 HAMPSTED VILLAGE CENTER WAY",
            "address_2": "#256",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430548331",
            "telephone_number": "614-855-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944715",
            "telephone_number": "715-423-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST TO COAST WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-855-9961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Clary
• Richard W Clasen, M.D.
• Penny Rae Cleworth, RN
• Cline Counseling and Consulting, LLC
• Jessica Cline, MSW
• Kellyn Elizabeth Colby, O.T.R.
• Megan Colemer, MS,CFY-SLP
• Cook Family Chiropractic, SC
• Melissa Ruth Cook, D.C.
• Michael A Cook, D.C.

• Emergency Medicine Physician in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.