Organization Active NPI

Subdoc

  • Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1477023729
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SUBDOC
Practice address
7275 N Port Washington Rd Apt 314
Milwaukee, WI 53217-3337
Phone
(414) 467-8884
Fax
(414) 435-3126
NPI assigned
Nov 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Karina Chelsky
Title
Administrator
Phone
(414) 467-8884

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Clinic/Center 261Q00000X Primary
Research Clinic/Center 261QR1100X

Addresses

Primary practice location

7275 N Port Washington Rd Apt 314
Milwaukee, WI 53217-3337

Mailing address

7275 N Port Washington Rd Apt 314
Milwaukee, WI 53217-3337
Phone (414) 467-8884

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1477023729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7275 N PORT WASHINGTON RD APT 314",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532173337",
            "telephone_number": "414-467-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7275 N PORT WASHINGTON RD APT 314",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532173337",
            "telephone_number": "414-467-8884",
            "fax_number": "414-435-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBDOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "CHELSKY",
        "authorized_official_first_name": "KARINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "414-467-8884"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.