Keith Kenji Sano, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

39387020 Issued in WI

Practice address

744 S Webster Ave
Green Bay, WI 54301-3505

Phone

(920) 433-3500

Fax

(920) 433-7932

NPI assigned

Nov 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Green Bay Emergency Medicine Services S.C.

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1366424111
  NPD (past)

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275516072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3500",
            "fax_number": "920-433-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANO",
        "first_name": "KEITH",
        "middle_name": "KENJI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "39387020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32397100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaenette Sandoval
• Jon Franklin Sandoval
• Heather Sanford
• Kenneth Roy Sann, LCSW, CSAC, ICS
• Yusupha Sanneh
• Santa Maria Nursing Home, Inc.
• Daniela Santiago Escamilla, MA, LPC-IT
• Thomas J Saphner, M.D.
• Bradley D Sarder, DPT
• Megan Kaye O'Brion Sarder, FNP-C

• Emergency Medicine Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.