Individual provider Active NPI

Mark Klewin, H,I.S.

  • Hearing Instrument Specialist
  • Madison, WI
National Provider Identifier
1114191996
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1293-060 Issued in WI
Practice address
4038 E Towne Blvd
Madison, WI 53704-3734
Phone
(608) 240-2900
Fax
(920) 887-9655
NPI assigned
Apr 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1293-060 WI Primary

Addresses

Primary practice location

4038 E Towne Blvd
Madison, WI 53704-3734

Mailing address

140 Corporate Dr
Suite 1
Beaver Dam, WI 53916-1281
Phone (920) 887-2822

Other identifiers 1

IdentifierTypeStateIssuer
42840300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1293-060WIMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1114191996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 CORPORATE DR",
            "address_2": "SUITE 1",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161281",
            "telephone_number": "920-887-2822",
            "fax_number": "920-887-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4038 E TOWNE BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043734",
            "telephone_number": "608-240-2900",
            "fax_number": "920-887-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEWIN",
        "first_name": "MARK",
        "credential": "H,I.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WI",
            "license": "1293-060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42840300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.