Independent Physicians of Wisconsin LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

INDEPENDENT PHYSICIANS OF WISCONSIN LLC

Practice address

140 E. Water St. Ste 1
West Bend, WI 53095-3415

Phone

(262) 355-8010

Fax

(262) 355-8011

NPI assigned

Jan 10, 2018

Organization subpart

Yes

Parent organization

INDEPENDENT PHYSICIANS OF WISCONSIN, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Carey Cameron, MD

Title

Managing Member

Phone

(262) 355-8010

Specialties & licenses 3

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Independent Physicians of Wisconsin LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Independent Physicians of Wisconsin, LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1871975920
  NPPES parent name

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1326555442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5434 W. CAPITOL DR SUITE 3",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162298",
            "telephone_number": "414-875-0505",
            "fax_number": "414-875-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E. WATER ST. STE 1",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953415",
            "telephone_number": "262-355-8010",
            "fax_number": "262-355-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICIANS OF WISCONSIN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPENDENT PHYSICIANS OF WISCONSIN, LLC",
        "enumeration_date": "2018-01-10",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "CAREY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "262-355-8010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in West Bend, WI
• Providers in West Bend, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.