Individual provider Active NPI

Carrie Lee Cosgrove, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • West Milwaukee, WI
National Provider Identifier
1407420177
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
129441 Issued in WI
Practice address
1610 Miller Park Way
West Milwaukee, WI 53214-3604
Phone
(414) 651-8033
NPI assigned
May 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WA0400X 129441 WI Primary

Addresses

Primary practice location

1610 Miller Park Way
West Milwaukee, WI 53214-3604

Mailing address

5071 W Colonial CT
Greenfield, WI 53220-2012
Phone (141) 465-1803

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL cosgrove1904@gmail.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
129441WIMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1407420177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5071 W COLONIAL CT",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532202012",
            "telephone_number": "141-465-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MILLER PARK WAY",
            "city": "WEST MILWAUKEE",
            "state": "WI",
            "postal_code": "532143604",
            "telephone_number": "414-651-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSGROVE",
        "first_name": "CARRIE",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "129441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cosgrove1904@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1610 Miller Park Way",
            "city": "West Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532143604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.