Damien Payne

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

100043804 Issued in WI

Practice address

1087 Westport Dr Apt 155
Port Washington, WI 53074-2481

Phone

(414) 208-0605

Fax

(262) 364-2336

NPI assigned

Jul 27, 2015

Last updated

Jul 27, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1053796524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1087 WESTPORT DR APT 155",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530742481",
            "telephone_number": "414-208-0605",
            "fax_number": "262-364-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 WESTPORT DR APT 155",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530742481",
            "telephone_number": "414-208-0605",
            "fax_number": "262-364-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "DAMIEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "WI",
            "license": "100043804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100043804",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ozaukee County Department Human Services
• Ozaukee County Public Health Department
• Ozaukee County Public Health Department
• Ozaukee County Public Health Department
• Nicole Anne Parulski, DPT
• Pearl32 Family Dentistry LLC
• Sherry L Peck, LPC, ATR
• Bonnie Louise Penkwitz, CERTIFIED NURSING AS
• Celestino F Perez, D.D.S
• Cheryl M Petersen, PT

• Non-emergency Medical Transport (VAN) in Port Washington, WI
• Providers in Port Washington, WI by specialty
• Non-emergency Medical Transport (VAN) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.