NPIMap

Organization Active NPI

Southport Transportation Inc

  • Non-emergency Medical Transport (VAN)
  • Kenosha, WI
National Provider Identifier
1275883787
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
SOUTHPORT TRANSPORTATION INC
Practice address
5911 57TH Ave
Kenosha, WI 53144-2240
Phone
(262) 658-3674
Fax
(262) 658-4779
NPI assigned
Sep 12, 2012
Last updated
Sep 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
Mr. Michael F Nardi
Title
President
Phone
(262) 658-3674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X NU Primary

Addresses

Primary practice location

5911 57TH Ave
Kenosha, WI 53144-2240

Mailing address

5911 57TH Ave
Kenosha, WI 53144-2240
Phone (262) 658-3674

Other identifiers 1

IdentifierTypeStateIssuer
100022665MedicaidWI

National Provider Directory

National Provider Directory

Locations

5911 57th Ave
Kenosha, WI 53144
Phone (262) 658-3674

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1275883787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 57TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442240",
            "telephone_number": "262-658-3674",
            "fax_number": "262-658-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 57TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442240",
            "telephone_number": "262-658-3674",
            "fax_number": "262-658-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPORT TRANSPORTATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "NARDI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-658-3674",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100022665",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.