NPIMap

Organization Active NPI

Wisconsin Medical Specialists SC

  • Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1801561394
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WISCONSIN MEDICAL SPECIALISTS SC
Practice address
11414 W. Park Place
Suite 202
Milwaukee, WI 53224
Phone
(800) 557-8950
NPI assigned
Aug 16, 2021
Last updated
Aug 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

Name
Hirenkumar Italia
Title
MD
Phone
(800) 557-8950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

11414 W. Park Place
Suite 202
Milwaukee, WI 53224

Mailing address

133 Rollins Ave Ste 3
Rockville, MD 20852-4040

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1801561394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 ROLLINS AVE STE 3",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11414 W. PARK PLACE",
            "address_2": "SUITE 202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53224",
            "telephone_number": "800-557-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN MEDICAL SPECIALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "ITALIA",
        "authorized_official_first_name": "HIRENKUMAR",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "800-557-8950"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 30, 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.