Barnett Wamboldt Eyecare, SC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2407-035 Issued in WI

Legal business name

BARNETT WAMBOLDT EYECARE, SC

Practice address

6116-39 Ave
Kenosha, WI 53142

Phone

(262) 653-0100

Fax

(262) 653-0200

NPI assigned

Sep 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Debra Jeanne Barnett-Wamboldt, O.D.

Title

President

Phone

(262) 697-3665

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Tax ID family

Barnett Wamboldt Eyecare SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Barnett Wamboldt Eyecare, SC

  • Optometrist
  • Kenosha, WI
  • NPI 1528622669
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Barnett Wamboldt Eyecare, SC

  • Optometrist
  • Kenosha, WI
  • NPI 1528622669
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra Jeanne Barnett, O.D.

  • Optometrist
  • Kenosha, WI
  • NPI 1831183540
  Medicare reassignment

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1497905129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116-39 AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53142",
            "telephone_number": "262-653-0100",
            "fax_number": "262-653-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116-39 AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53142",
            "telephone_number": "262-653-0100",
            "fax_number": "262-653-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARNETT WAMBOLDT EYECARE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "BARNETT-WAMBOLDT",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-697-3665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "2407-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38585300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy L Bandstra, LCSW
• Daniel Baran, MA
• Kayla Marie Baran, PHYSICIAN ASSISTANT
• Collin Scott Barber
• Jennifer Barncard, LMT
• Barnett Wamboldt Eyecare, SC
• Debra Jeanne Barnett, O.D.
• James Edward Barnhart, RPH
• Lauren Barnhart
• Heather M Barrett, PA

• Primary Care Clinic/Center in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Primary Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.