NPIMap

Organization Active NPI

Beaver Dam Women's Health, LTD.

  • Obstetrics & Gynecology Physician
  • Beaver Dam, WI
National Provider Identifier
1346283595
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
36431 Issued in WI
Legal business name
BEAVER DAM WOMEN'S HEALTH, LTD.
Practice address
705 S. University Avenue
Suite 300
Beaver Dam, WI 53916
Phone
(920) 885-6090
Fax
(920) 885-6092
NPI assigned
Jun 14, 2006
Last updated
Jan 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Dr. Kenneth V Ostermann, MDNPI 1851386213
Title
President
Phone
(920) 885-6090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 36431 WI Primary

Addresses

Primary practice location

705 S. University Avenue
Suite 300
Beaver Dam, WI 53916

Mailing address

705 S. University Avenue
Suite 300
Beaver Dam, WI 53916
Phone (920) 885-6090

Other identifiers 1

IdentifierTypeStateIssuer
32893800MedicaidWI

National Provider Directory

National Provider Directory

Locations

707 S University Ave
Ste 400
Beaver Dam, WI 53916
Phone (414) 885-6090

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1346283595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S. UNIVERSITY AVENUE",
            "address_2": "SUITE 300",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "53916",
            "telephone_number": "920-885-6090",
            "fax_number": "920-885-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S. UNIVERSITY AVENUE",
            "address_2": "SUITE 300",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "53916",
            "telephone_number": "920-885-6090",
            "fax_number": "920-885-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER DAM WOMEN'S HEALTH, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "OSTERMANN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-885-6090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "36431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32893800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.