Provider Demographics
NPI:1932197357
Name:CARING TEAM INC
Entity Type:Organization
Organization Name:CARING TEAM INC
Other - Org Name:NEW BERLIN FAMILY PRACTICE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BEAUMONT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:262-782-9541
Mailing Address - Street 1:N69W29753 RIDGEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-9253
Mailing Address - Country:US
Mailing Address - Phone:262-782-9541
Mailing Address - Fax:262-782-6541
Practice Address - Street 1:15350 W NATIONAL AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5158
Practice Address - Country:US
Practice Address - Phone:262-782-9541
Practice Address - Fax:262-782-6541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000380260Medicare PIN