Mary Kay Benotsch, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

168085 Issued in WI

Practice address

505 South Washburn Street
Oshkosh, WI 54904

Phone

(920) 232-2332

NPI assigned

Sep 13, 2017

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Registered Nurse

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.

• Ams of Wisconsin LLC

  • Methadone Clinic
  • Oshkosh, WI
  • NPI 1740651330
  NPD (past)
• Ams of Wisconsin, LLC

  • Methadone Clinic
  • Onalaska, WI
  • NPI 1003150004
  NPD (past)

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326567140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047949",
            "telephone_number": "920-232-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 SOUTH WASHBURN STREET",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-232-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENOTSCH",
        "first_name": "MARY",
        "middle_name": "KAY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "168085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7754",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kent Lydell Belville, DC
• Nicholas Morris Belville, DC
• Benjamin G Benesh, PT
• Lacey A Benike
• John Andrew Bennett, DO
• Hannah Benson
• Hazel Benton, PSYCHOLOGY BS
• George Benz
• Kristin P Beougher, DO
• Scott J Beougher, DO

• Registered Nurse in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.