Active NPI
Beaver Dam ENT LLC
- Otolaryngology Physician
- Beaver Dam, WI
National Provider Identifier
1124277009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- Legal business name
- BEAVER DAM ENT LLC
- Practice address
- 707 S University Ave
Beaver Dam, WI 53916-3027 - Phone
- (920) 887-6383
- NPI assigned
- Sep 16, 2008
- Last updated
- Jan 23, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- K Scott Abrams, CPA
- Title
- Cfo
- Phone
- (920) 887-4041
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | NU | Primary |
Addresses
Primary practice location
707 S University Ave
Beaver Dam, WI 53916-3027
Mailing address
707 S University Ave
Beaver Dam, WI 53916-3027
Phone (920) 887-6383
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1232668800000",
"number": "1124277009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 S UNIVERSITY AVE",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539163027",
"telephone_number": "920-887-6383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 S UNIVERSITY AVE",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539163027",
"telephone_number": "920-887-6383"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEAVER DAM ENT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-16",
"last_updated": "2009-01-23",
"status": "A",
"authorized_official_last_name": "ABRAMS",
"authorized_official_first_name": "K",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "920-887-4041",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver Dam, WI
- Beaver Dam Community Hospitals Inc ((Inactive) Marshfield Medical Center - Beaver Dam Wound Clinic)
- Beaver Dam Community Hospitals Inc (Marshfield Medical Center - Beaver Dam Hospital InstyMeds)
- Beaver Dam Community Hospitals, Inc ((Inactive) MMC - Beaver Dam - Movement & Ortho, Rehab, PT/OT/ST)
- Beaver Dam Dental LLC
- Beaver Dam Emergency Medicine S.C.
- Beaver Dam Foot & Ankle Center, Inc.
- Beaver Dam Hearing Care, LLC
- Beaver Dam Hometown Pharmacy LLC (Beaver Dam Hometown Pharmacy)
- Beaver Dam Unified School District
- Beaver Dam Women's Health, LTD.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.