Eddy D Co,, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

19814 Issued in WI

Practice address

3267 S 16TH St
Suite 105
Milwaukee, WI 53215-4500

Phone

(414) 645-0920

NPI assigned

Sep 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment NPD

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1871697409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3267 S 16TH ST",
            "address_2": "SUITE 105",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154500",
            "telephone_number": "414-645-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3267 S 16TH ST",
            "address_2": "SUITE 105",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154500",
            "telephone_number": "414-645-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CO,",
        "first_name": "EDDY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "19814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30914600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "061917005",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Rae Closson
• Jeanne L Clow, O.T.
• Tina Cloyd-Brooks, APSW
• Anna Kathryn Cluskey, PA-C
• CMK Transportation
• Shannon N Coakley, PA
• Coalition for Community Empowerment
• Perry G. Coalmon, M.D.
• Candace E Coates
• Christina Michele Coates

• Cardiovascular Disease Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Cardiovascular Disease Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.