1Vision Outreach Resource Center

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

1VISION OUTREACH RESOURCE CENTER

Practice address

4123 N 44TH St
Milwaukee, WI 53216-1503

Phone

(414) 899-7753

NPI assigned

Sep 22, 2016

Last updated

Sep 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tamika L Jackson

Title

Director/Owner

Phone

(414) 899-7753

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1457800237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 N 44TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161503",
            "telephone_number": "414-899-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 N 44TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161503",
            "telephone_number": "414-899-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1VISION OUTREACH RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TAMIKA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "414-899-7753"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EISZUSP50K",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.