Active NPI
Medical Mobile Specialists S.C.
- General Practice Physician
- Pewaukee, WI
National Provider Identifier
1922441195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- MEDICAL MOBILE SPECIALISTS S.C.
- Doing business as
- Mobile Medical Specialists
- Practice address
- 347 Park Ave
Pewaukee, WI 53072-3413 - Phone
- (262) 691-1000
- Fax
- (262) 264-5429
- NPI assigned
- Apr 8, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jeffrey Osbourne, D.P.M.
- Title
- Owner
- Phone
- (262) 691-1000
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Dentist | 122300000X | |||
| Dental Hygienist | 124Q00000X | |||
| Dental Assistant | 126800000X | |||
| Optometrist | 152W00000X | |||
| Dermatology Physician | 207N00000X | |||
| Diagnostic Radiology Physician | 2085R0202X | |||
| General Practice Physician | 208D00000X | Primary | ||
| Podiatrist | 213E00000X | |||
| Pedorthist | 224L00000X | |||
| Physical Therapist | 225100000X | |||
| Audiologist | 231H00000X | |||
| Hearing Instrument Specialist | 237700000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
347 Park Ave
Pewaukee, WI 53072-3413
Mailing address
347 Park Ave
Pewaukee, WI 53072-3413
Phone (262) 691-1000
Other names 1
- Mobile Medical Specialists
National Provider Directory
National Provider DirectoryLocations
18740 W Bluemound Rd
Brookfield, WI 53045
Phone (262) 782-0230
1306 W Wisconsin Ave
Ste 1002
Oconomowoc, WI 53066
Phone (262) 520-2300
347 Park Ave
Pewaukee, WI 53072
Phone (262) 691-1000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1365379200000",
"number": "1922441195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "347 PARK AVE",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530723413",
"telephone_number": "262-691-1000",
"fax_number": "262-264-5429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "347 PARK AVE",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530723413",
"telephone_number": "262-691-1000",
"fax_number": "262-264-5429"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL MOBILE SPECIALISTS S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-08",
"last_updated": "2013-04-08",
"status": "A",
"authorized_official_last_name": "OSBOURNE",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "262-691-1000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.P.M."
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": false
},
{
"code": "126800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "224L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pedorthist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "237700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hearing Instrument Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mobile Medical Specialists",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.