PROVIDENCE FAMILY MEDICAL CLINIC S.C
NPI 1861857542
Clinic/Center - Primary Care in Glendale, WI

NPI Status: Active since December 22, 2015

Contact Information

2500 W SILVER SPRING DR
GLENDALE, WI
ZIP 53209
Phone: (414) 800-7171
Fax: (414) 800-7166

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  • 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
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ADEDAPO F OKUSANYA M.D.

Authorized Official Title
PRESIDENT
Authorized Official Phone
(269) 598-7404

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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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1861857542, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
1
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
5
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
5
Unchanged
Pos 9
4
Doubled → 8
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 8 → 16 → 7 7 → 14 → 5 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 2 + 1 + 1 + 6 + 5 + 1 + 4 + 5 + 8 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1861857542.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Pediatrics
2500 W SILVER SPRING DR, SUITE C
GLENDALE, WI 53209
Family Medicine
2500 W SILVER SPRING DR
GLENDALE, WI 53209
Physical Therapist
2500 W SILVER SPRING DR
MILWAUKEE, WI 53209
Chiropractor
2500 W SILVER SPRING DR
GLENDALE, WI 53209
Clinic/Center (Physical Therapy)
2500 W SILVER SPRING DR, STE A
GLENDALE, WI 53209
Pharmacy (Community/Retail Pharmacy)
2500 W SILVER SPRING DR
GLENDALE, WI 53209
Pharmacy
2500 W SILVER SPRING DR
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.