Phoenix Rising PNCC LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PHOENIX RISING PNCC LLC

Practice address

423 W Center St
Milwaukee, WI 53212-2724

Phone

(262) 349-8560

Fax

(414) 635-3157

NPI assigned

Apr 9, 2021

Organization subpart

No

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

Authorized official

Name

Carla Bernard Gamble

Title

Sole Member

Phone

(262) 349-8560

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1760062236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 W CENTER ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122724",
            "telephone_number": "262-349-8560",
            "fax_number": "414-635-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 W CENTER ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122724",
            "telephone_number": "262-349-8560",
            "fax_number": "414-635-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING PNCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "262-349-8560"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jill Phillips, OTR/L
• Kathleen Vincent Phillipson, LMFT
• Catherine Philson, CCP
• Kristy Marie Phipps, COTA
• Phoenix Housing Foundation, Limited
• Phoenix Rising Wellness, LLC
• Kelly Phoungphol
• Douangmala Phrasavath
• Physiatrists Associates, LTD
• Physical Therapy and Balance Center Inc

• Case Management Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Case Management Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.