Southside Primary Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2826033 Issued in WI

Legal business name

SOUTHSIDE PRIMARY CARE

Practice address

2727 W Cleveland Ave
Milwaukee, WI 53215-2908

Phone

(414) 384-5420

Fax

(414) 384-0134

NPI assigned

Jan 15, 2007

Organization subpart

No

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

Authorized official

Name

Miss Carlisa Rivera-Robles, RN, APNP

Title

Family Nurse Practitioner

Phone

(414) 384-5420

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871644047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3053 W DREXEL AVE",
            "address_2": "UNIT 121",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531327923",
            "telephone_number": "414-389-9992",
            "fax_number": "414-384-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W CLEVELAND AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152908",
            "telephone_number": "414-384-5420",
            "fax_number": "414-384-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIVERA-ROBLES",
        "authorized_official_first_name": "CARLISA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "414-384-5420",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RN, APNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "2826033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeastern Pediatric & Adolescent Medicine, S.C. (Southeastern Pediatric & Adolescent Medicine)
• Southern Home Health
• Southern Lakes Physical Therapy
• James F Southern, MD
• Southside Pediatrics Assoc
• Southwest Pharmacy Inc (The Pharmacy Shoppe)
• Janet Marie Sova, C.O.T.A.
• Alexis Ann Sover, PA-C
• Sovereigns Circle of Love Prenatal Assessment Program
• Christopher Sowder, ED.S.

• Primary Care Clinic/Center in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Primary Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.