NPIMap

Organization Active NPI

CSM Community Physician

  • Medical Specialty Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1801100243
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
CSM COMMUNITY PHYSICIAN
Practice address
2350 N Lake Dr
Suite 206
Milwaukee, WI 53211-4528
Phone
(414) 298-7280
Fax
(414) 298-7281
NPI assigned
Jul 27, 2010
Organization subpart
Yes
Parent organization
COLUMBIA ST MARYS HOSPITAL MILWAUKEE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Ms. Deborah E Bjorn
Title
Practice Administrator
Phone
(414) 298-7284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

2350 N Lake Dr
Suite 206
Milwaukee, WI 53211-4528

Mailing address

PO Box 78309
Milwaukee, WI 53278-0001
Phone (414) 298-7280

Other identifiers 1

IdentifierTypeStateIssuer
32793800MedicaidWI

Other names 1

  • CSMCP Cardiac Rhythm Specialist Other name

National Provider Directory

National Provider Directory
Tax ID family
North Lake Medical Asso8 organizations share this tax ID, including this one
Part of
North Lake Medical Asso

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1801100243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78309",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532780001",
            "telephone_number": "414-298-7280",
            "fax_number": "414-298-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "address_2": "SUITE 206",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-298-7280",
            "fax_number": "414-298-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSM COMMUNITY PHYSICIAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "BJORN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "414-298-7284",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32793800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSMCP Cardiac Rhythm Specialist",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 24, 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.