SOUTHSIDE PRIMARY CARE – NPI #1871644047
Clinic/Center

SOUTHSIDE PRIMARY CARE is an AHC clinic located in MILWAUKEE, WI. NPPES has assigned the NPI number 1871644047 to SOUTHSIDE PRIMARY CARE on January 15, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHSIDE PRIMARY CARE below.

NPI Profile for
SOUTHSIDE PRIMARY CARE

NPI Number
1871644047
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHSIDE PRIMARY CARE
Primary location
2727 W CLEVELAND AVE
MILWAUKEE, WI 53215-2908
Phone: (414) 384-5420 Fax: (414) 384-0134
Mailing address
3053 W DREXEL AVE
UNIT 121
FRANKLIN, WI 53132-7923
Phone: (414) 389-9992 Fax: (414) 384-0134
Organization Subpart
No
Authorized Official
CARLISA RIVERA-ROBLES
FAMILY NURSE PRACTITIONER
Phone: (414) 384-5420
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)		 WI 2826033

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.