Independent Physicians of Wisconsin, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

INDEPENDENT PHYSICIANS OF WISCONSIN, LLC

Practice address

5434 W Capitol Dr Ste 3
Milwaukee, WI 53216-2298

Phone

(414) 875-0505

Fax

(414) 875-6786

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

Mohammad Qasim Khan, MD

Title

Partner

Phone

(414) 875-0505

Specialties & licenses 3

Addresses

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": "1515542400000",
    "number": "1366959447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5434 W CAPITOL DR STE 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": "5434 W CAPITOL DR STE 3",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162298",
            "telephone_number": "414-875-0505",
            "fax_number": "414-875-6786"
        }
    ],
    "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": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "QASIM",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "414-875-0505",
        "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": []
}

• Independent Care Health Plan
• Independent Family Service Providers of Milwaukee
• Independent Lifestyle Supportive Homecare LLC
• Independent Nurse
• Independent Physicians of Wisconsin, LLC
• Independent Physicians of Wisconsin, LLC
• Independent Physicians of Wisconsin, LLC
• Independent Physicians of Wisconsin, LLC
• Independent Physicians of Wisconsin, LLC
• Audra Indermuehle

• Durable Medical Equipment & Medical Supplies in Milwaukee, WI
• Providers in Milwaukee, 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 Jan 10, 2018; 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.