PROVIDENCE FAMILY MEDICAL CLINIC S.C
NPI 1861857542
Clinic/Center - Primary Care in Glendale, WI
- Organization
- Clinic/Center
- Primary Care
- Accepts Insurance
- CLIA Number: 52D2108037
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-26-2028
About PROVIDENCE FAMILY MEDICAL CLINIC S.C
This page provides the complete NPI Profile along with additional information for Providence Family Medical Clinic S.c, a primary care provider established in Glendale, Wisconsin operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1861857542 assigned on December 2015. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Dr. Adedapo F Okusanya M.d. (President)
- NPI
- 1861857542 Verify this NPI
- Provider Name
- PROVIDENCE FAMILY MEDICAL CLINIC S.C
- Entity Type
- Organization
- Location Address
- 2500 W SILVER SPRING DR GLENDALE, WI 53209
- Location Phone
- (414) 800-7171
- Location Fax
- (414) 800-7166
- Mailing Address
- 2500 W SILVER SPRING DR GLENDALE, WI 53209
- Mailing Phone
- (414) 800-7171
- Mailing Fax
- (414) 800-7166
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-22-2015
- Last Update Date
- 12-22-2015
- Code Navigator
A primary care provider (PCP) like Providence Family Medical Clinic S.c sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Primary Care
- Taxonomy Code
- 261QP2300X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D2108037
- Facility Type
- Physician Office
- Certificate Effective Date
- January 27, 2026
- Certificate Expiration Date
- January 26, 2028
- Laboratory Director
- DR. ADEDAPO F. OKUSANYA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Providence Family Medical Clinic S.c to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for PROVIDENCE FAMILY MEDICAL CLINIC S.C
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Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
GLENDALE, WI 53209
GLENDALE, WI 53209
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1861857542, enumerated as an "organization" on December 22, 2015.
The provider is located at 2500 W SILVER SPRING DR GLENDALE, WI 53209 and the phone number is (414) 800-7171.
Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
