Active NPI
Dean G Kresge, MD
- Family Medicine Physician
- Stoughton, WI
National Provider Identifier
1255383394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25971-020
- Practice address
- 225 Church St
Dean Medical Center
Stoughton, WI 53589-1801 - Phone
- (608) 877-2700
- Fax
- (608) 877-2774
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25971-020 | WI | Primary |
Addresses
Primary practice location
225 Church St
Dean Medical Center
Stoughton, WI 53589-1801
Mailing address
225 Church St
Dean Medical Center
Stoughton, WI 53589-1801
Phone (608) 877-2700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30755800 | Medicaid | WI | |
| 474 | Other | WI | DEAN HEALTH INSURANCE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25971-020 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210291200000",
"number": "1255383394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 CHURCH ST",
"address_2": "DEAN MEDICAL CENTER",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535891801",
"telephone_number": "608-877-2700",
"fax_number": "608-877-2774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 CHURCH ST",
"address_2": "DEAN MEDICAL CENTER",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535891801",
"telephone_number": "608-877-2700",
"fax_number": "608-877-2774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRESGE",
"first_name": "DEAN",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2008-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "25971-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30755800",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH INSURANCE",
"identifier": "474",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stoughton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.