THIRD COAST RETINA S.C. – NPI #1831823921
Ophthalmology

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Health Care Provider Taxonomy Code for Ophthalmology

THIRD COAST RETINA S.C. is an ophthalmologist located in KENOSHA, WI. NPPES has assigned the NPI number 1831823921 to THIRD COAST RETINA S.C. on July 13, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207WX0107X from the Health Care Provider Taxonomy code set, which is classified as Ophthalmology, specializing in Retina Specialist

The NPI profile was previously updated about 4 years ago on Aug 10, 2022. 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 THIRD COAST RETINA S.C. below.

NPI Profile for
THIRD COAST RETINA S.C.

NPI Number
1831823921
Enumeration Date

(about 4 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
THIRD COAST RETINA S.C.
Primary location
5017 GREEN BAY RD STE 148
KENOSHA, WI 53144-1782
Phone: (262) 420-5888 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
CLINTON WARREN
PRESIDENT
Phone: (262) 420-5888
Updated
Certification Date
Aug 10, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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
207WX0107X
- Ophthalmology / Retina Specialist (Primary)

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.