Organization Active NPI

Diabetes Osteoporosis Thyroid Endocrine Center, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Mount Pleasant, WI
National Provider Identifier
1679735997
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
41940020 Issued in WI
Legal business name
DIABETES OSTEOPOROSIS THYROID ENDOCRINE CENTER, LLC
Practice address
1532 S Green Bay Rd Ste 300
Mount Pleasant, WI 53406-4410
Phone
(262) 619-3473
Fax
(262) 619-3473
NPI assigned
Jun 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Authorized official

Name
Ms. Julie Hardy
Title
Office Manager
Phone
(262) 619-3473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 41940020 WI Primary

Addresses

Primary practice location

1532 S Green Bay Rd Ste 300
Mount Pleasant, WI 53406-4410

Mailing address

4077 Lighthouse Dr
Racine, WI 53402-3113
Phone (262) 619-3473

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420156800000",
    "number": "1679735997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4077 LIGHTHOUSE DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534023113",
            "telephone_number": "262-619-3473",
            "fax_number": "262-619-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 S GREEN BAY RD STE 300",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064410",
            "telephone_number": "262-619-3473",
            "fax_number": "262-619-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES OSTEOPOROSIS THYROID ENDOCRINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2015-01-02",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "262-619-3473",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "41940020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.