Organization Active NPI

Medical Mobile Specialists S.C.

  • General Practice Physician
  • Pewaukee, WI
National Provider Identifier
1922441195
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
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

Updated by the provider on Apr 8, 2013

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)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X
Dental AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 126800000X
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
PedorthistGroup: 193200000X MULTI-SPECIALTY GROUP 224L00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
Hearing Instrument SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 237700000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.