Active NPI
Norman Keaton Fox
- Professional Counselor
- Appleton, WI
National Provider Identifier
1245802644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5017-226
- Practice address
- 711 N Lynndale Dr Ste 1a
Appleton, WI 54914-3078 - Phone
- (920) 560-4524
- Fax
- (920) 560-6618
- NPI assigned
- Jul 14, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5017-226 | WI | Primary |
Addresses
Primary practice location
711 N Lynndale Dr Ste 1a
Appleton, WI 54914-3078
Mailing address
4381 N Orion LN
Appleton, WI 54913-6405
Phone (920) 216-2176
Other practice location 1
4381 N Orion Ln
Appleton, WI 54913-6405
Phone (920) 216-2176
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5017-226 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GJB Health Services, LLC | Professional | Current | Accepting new patients |
| GJB Eeg Services, SC | Single Specialty | Current | Accepting new patients |
Locations
711 N Lynndale Dr
Ste 1A
Appleton, WI 54914
Phone (920) 217-7861
Interoperability endpoints
- https://api.platform.athenahealth.com/22083/brand/1/csg/1/fhir/r4
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626220800000",
"number": "1245802644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4381 N ORION LN",
"city": "APPLETON",
"state": "WI",
"postal_code": "549136405",
"telephone_number": "920-216-2176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 N LYNNDALE DR STE 1A",
"city": "APPLETON",
"state": "WI",
"postal_code": "549143078",
"telephone_number": "920-560-4524",
"fax_number": "920-560-6618"
}
],
"practiceLocations": [
{
"address_1": "4381 N Orion Ln",
"address_purpose": "LOCATION",
"city": "Appleton",
"state": "WI",
"postal_code": "549136405",
"country_code": "US",
"telephone_number": "920-216-2176",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOX",
"first_name": "NORMAN",
"middle_name": "KEATON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-14",
"last_updated": "2021-07-14",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "WI",
"license": "5017-226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.