Active NPI
Michael John Balfanz, WLMT
- Contractor
- Stoughton, WI
National Provider Identifier
1265818843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 146-11537
- Practice address
- 2585 Door Creek Rd
Stoughton, WI 53589-2842 - Phone
- (608) 712-2775
- NPI assigned
- Aug 5, 2015
- Last updated
- Aug 5, 2015
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 146-11537 | WI | Primary |
Addresses
Primary practice location
2585 Door Creek Rd
Stoughton, WI 53589-2842
Mailing address
2585 Door Creek Rd
Stoughton, WI 53589-2842
Phone (608) 712-2775
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 |
|---|---|---|---|
| 146-11537 | WI | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1265818843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2585 DOOR CREEK RD",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535892842",
"telephone_number": "608-712-2775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2585 DOOR CREEK RD",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535892842",
"telephone_number": "608-712-2775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALFANZ",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"credential": "WLMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-05",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WI",
"license": "146-11537",
"primary": true
}
],
"identifiers": [],
"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 Aug 5, 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.