NPIMap

Organization Active NPI

Minuteclinic Video Virtual Care of Wisconsin, SC

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1932732914
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MINUTECLINIC VIDEO VIRTUAL CARE OF WISCONSIN, SC
Practice address
1650 N Farwell Ave
Milwaukee, WI 53202-2331
Phone
(866) 389-2727
NPI assigned
Feb 18, 2020
Last updated
May 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Deborah Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

1650 N Farwell Ave
Milwaukee, WI 53202-2331

Mailing address

1 CVS Dr # Mc2295
Woonsocket, RI 02895-6146
Phone (866) 389-2727

Other practice location 1

1 Cvs Dr
Woonsocket, RI 02895-6146
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200727003573 WI Part B Supplier - Clinic/Group Practice 0547684243 Receives reassigned benefits from 38 practitioners
Practice locations: Milwaukee, WI

National Provider Directory

National Provider Directory
Tax ID family
Minuteclinic Video Virtual Care of Wisconsin SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1932732914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR # MC2295",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 N FARWELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022331",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Cvs Dr",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028956146",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINUTECLINIC VIDEO VIRTUAL CARE OF WISCONSIN, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-18",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.