NPIMap

Organization Active NPI

North Shore Podiatry, Inc.

  • Podiatrist
  • Milwaukee, WI
National Provider Identifier
1295819118
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
658025 Issued in WI
Legal business name
NORTH SHORE PODIATRY, INC.
Practice address
8003 N Port Washington Rd
Milwaukee, WI 53217-2647
Phone
(414) 228-6444
Fax
(414) 228-7005
NPI assigned
Oct 25, 2006
Last updated
Sep 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Dr. Clifford D Greenbaum, D.P.M.NPI 1003990961
Title
President
Phone
(414) 228-6444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 658025 WI Primary

Addresses

Primary practice location

8003 N Port Washington Rd
Milwaukee, WI 53217-2647

Mailing address

8003 N Port Washington Rd
Milwaukee, WI 53217-2647
Phone (414) 228-6444

Other identifiers 1

IdentifierTypeStateIssuer
43214600MedicaidWI

Other names 1

  • Oak Creek Podiatry Other name

National Provider Directory

National Provider Directory

Locations

8003 N Port Washington Rd
Milwaukee, WI 53217
Phone (414) 228-6444

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1295819118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 N PORT WASHINGTON RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532172647",
            "telephone_number": "414-228-6444",
            "fax_number": "414-228-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8003 N PORT WASHINGTON RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532172647",
            "telephone_number": "414-228-6444",
            "fax_number": "414-228-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PODIATRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "GREENBAUM",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-228-6444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "658025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43214600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Creek Podiatry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.