Individual provider Active NPI

Cullen Timothy Kehoe, DO

  • Emergency Medicine Physician
  • Lake Geneva, WI
National Provider Identifier
1013166925
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
53435-21 Issued in WI
Practice address
N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone
(262) 245-4990
Fax
(262) 245-2248
NPI assigned
Sep 16, 2008
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11215 ND
Emergency Medicine Physician 207P00000X 036122047 IL
Emergency Medicine Physician 207P00000X 53435-21 WI Primary

Addresses

Primary practice location

N2950 State Road 67
Lake Geneva, WI 53147-2655

Mailing address

N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone (262) 245-4990

Other practice location 1

1700 W Stout St
Rice Lake, WI 54868-5000
Phone (715) 234-1515

Other practice location 2

2305 37th Ave SW
Minot, ND 58701-7669
Phone (701) 418-8000

Other identifiers 3

IdentifierTypeStateIssuer
KEHOECULOtherWIMERCYCARE INSURANCE
1013166925OtherWIBCBSWI
1013166925MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091005000667 WI Practitioner - Emergency Medicine 5496808289 Reassigns benefits to 10 organizations
I20100909000660 IL Practitioner - Emergency Medicine 5496808289 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Medical CenterGroup PAC ID 5698771848, 36 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Galena, IL 61036-8118
Phone (815) 777-1340

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036122047ILMDEmergency Medicine Physician
11215NDMDEmergency Medicine Physician
53435-21WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Dec 2, 2022 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2020 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Feb 26, 2021 Accepting new patients
MCHS Hospitals Inc Emergency Medicine Current Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Midwest Medical Center CurrentSince Apr 15, 2017 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 2, 2022 Accepting new patients
Memorial Hospital Inc CurrentSince Dec 2, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 17, 2020 Accepting new patients
Mercy Health System Corporation CurrentSince Feb 21, 2016 Accepting new patients
Mercy Health System Corporation CurrentSince Feb 21, 2016 Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 2, 2022 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Feb 26, 2021 Accepting new patients
Board of Trustees of the University of Illinois Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Marshfield Clinic Inc CurrentSince Apr 17, 2020 Accepting new patients
Midwest Medical Center CurrentSince Apr 15, 2017 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 17, 2020 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 2, 2022 Accepting new patients
Memorial Hospital Inc Past Accepting new patients
Flambeau Hospital Inc Past Accepting new patients

Locations

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

1 Medical Center Dr
Galena, IL 61036
Phone (815) 776-7381

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

901 Grant St
Harvard, IL 60033
Phone (815) 943-2961

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

2661 County Highway I
Chippewa Fls, WI 54729
Phone (715) 717-7200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: cullen.kehoe@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 22

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 22

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1013166925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2950 STATE ROAD 67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472655",
            "telephone_number": "262-245-4990",
            "fax_number": "262-245-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2950 STATE ROAD 67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472655",
            "telephone_number": "262-245-4990",
            "fax_number": "262-245-2248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 W Stout St",
            "address_purpose": "LOCATION",
            "city": "Rice Lake",
            "state": "WI",
            "postal_code": "548685000",
            "country_code": "US",
            "telephone_number": "715-234-1515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2305 37th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587017669",
            "country_code": "US",
            "telephone_number": "701-418-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEHOE",
        "first_name": "CULLEN",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2026-09-29",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ND",
            "license": "11215",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036122047",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "53435-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "KEHOECUL",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWI",
            "identifier": "1013166925",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013166925",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1700 W Stout St",
            "city": "Rice Lake",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548685000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

Verify at the official NPI Registry.