Wolfe Mobile Medical LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

29319-020 Issued in WI

Legal business name

WOLFE MOBILE MEDICAL LLC

Practice address

510 Grey Fox Run
Watertown, WI 53094-5901

Phone

(920) 253-5851

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Andrew Wolfe, MD

Title

Member

Phone

(920) 253-5851

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1265611586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 GREY FOX RUN",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530945901",
            "telephone_number": "920-253-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 GREY FOX RUN",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530945901",
            "telephone_number": "920-253-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLFE MOBILE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "920-253-5851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "29319-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI ENUMERATOR",
            "identifier": "1003998394",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31425500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI, DEPT REGULATION & LIS",
            "identifier": "29319",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karl Winek, PT
• Wisconsin Lutheran Child & Family Service, Inc
• Wisconsin Physician Services SC
• Sarah Renee Wittak, OTD, OTR/L, CHT
• Cindy D Wolf, LPN
• Donald Alan Wollheim, MD WCC
• Jean Marie Wurster
• Brent Paul Yaeggi, DPM
• Mohamed H Yafai, MD
• Patricia Ann Yantis, RN

• Primary Care Clinic/Center in Watertown, WI
• Providers in Watertown, WI by specialty
• Primary Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.