Carol Gaines, M.D.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

25320-020 Issued in WI

Practice address

2448 S 102ND St
Suite 270
West Allis, WI 53227-2466

Phone

(414) 543-9600

Fax

(414) 543-9601

NPI assigned

Dec 11, 2008

Last updated

Dec 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1982849543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 EAST WISCONSIN AVENUE",
            "address_2": "SUITE 208",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53202",
            "telephone_number": "414-731-0019",
            "fax_number": "414-271-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST",
            "address_2": "SUITE 270",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272466",
            "telephone_number": "414-543-9600",
            "fax_number": "414-543-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WI",
            "license": "25320-020",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "IL",
            "license": "036.119429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin H Frost, OTR
• Kezza Frye
• Janet Luann Fullmer, PT
• Torsten Furumo, DC
• Nathan Paul Gabler, M.D.
• Eric Gajewski, MASSAGE THERAPIST
• Paul Galleske
• Michael Ganas, D.C.
• Elizabeth Jane Garbe, ISW, MSW
• Maryam Gardezi, M.D.

• Community Health Worker in West Allis, WI
• Providers in West Allis, WI by specialty
• Community Health Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.