Organization Active NPI

Wilson Heart Care Associates LTD

  • Cardiovascular Disease Physician
  • Mequon, WI
National Provider Identifier
1770505885
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
WILSON HEART CARE ASSOCIATES LTD
Practice address
1330 W Towne Square Rd
Mequon, WI 53092-5046
Phone
(262) 241-1441
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Authorized official

Name
Bruce C Wilson, MD
Title
Owner/President
Phone
(262) 241-1441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1330 W Towne Square Rd
Mequon, WI 53092-5046

Mailing address

1330 W Towne Square Rd
Mequon, WI 53092-5046
Phone (262) 241-1441

Other identifiers 1

IdentifierTypeStateIssuer
31711400MedicaidWI

National Provider Directory

National Provider Directory

Locations

5555 N Port Washington Rd
Ste 204
Glendale, WI 53217
Phone (414) 963-1441

1330 W Towne Square Rd
Mequon, WI 53092
Phone (262) 241-1441

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1770505885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W TOWNE SQUARE RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925046",
            "telephone_number": "262-241-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W TOWNE SQUARE RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925046",
            "telephone_number": "262-241-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON HEART CARE ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "262-241-1441",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31711400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; 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.