NPIMap

Organization Active NPI

CSM Community Physician

Doing business as CSMCP Cardiac Rhythm Specialist

  • Medical Specialty Clinic/Center
  • Oshkosh, WI
National Provider Identifier
1366773780
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
CSM COMMUNITY PHYSICIAN
Doing business as
CSMCP Cardiac Rhythm Specialist
Practice address
2700 W 9TH Ave
Suite 106
Oshkosh, WI 54904-7247
Phone
(414) 298-7280
Fax
(414) 298-7281
NPI assigned
Jan 25, 2010
Last updated
Nov 24, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
COLUMBIA ST MARYS HOSPITAL MILWAUKEE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Ms. Deborah E Bjorn
Title
Practice Administrator
Phone
(414) 298-7284

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary
Medical Physician Assistant 363AM0700X
Acute Care Nurse Practitioner 363LA2100X
Clinical Cardiac Electrophysiology Physician 207RC0001X

Addresses

Primary practice location

2700 W 9TH Ave
Suite 106
Oshkosh, WI 54904-7247

Mailing address

PO Box 78309
Milwaukee, WI 53278-0001
Phone (414) 298-7280

Other identifiers 1

IdentifierTypeStateIssuer
32793800MedicaidWI

Other names 1

  • CSMCP Cardiac Rhythm Specialist Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Marys Medical Clinic8 organizations share this tax ID, including this one
Part of
St Marys Medical Clinic

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1366773780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78309",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532780001",
            "telephone_number": "414-298-7280",
            "fax_number": "414-298-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W 9TH AVE",
            "address_2": "SUITE 106",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047247",
            "telephone_number": "414-298-7280",
            "fax_number": "414-298-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSM COMMUNITY PHYSICIAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC",
        "enumeration_date": "2010-01-25",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "BJORN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "414-298-7284",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32793800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSMCP Cardiac Rhythm Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.