Active NPI
Matt Hellmer, H.I.S.
- Hearing Instrument Specialist
- Fond Du Lac, WI
National Provider Identifier
1376731018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 1183-060
- Practice address
- 1211 Rickmeyer Dr
Suite CC
Fond Du Lac, WI 54937-2213 - Phone
- (920) 922-6640
- NPI assigned
- Oct 9, 2007
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 1183-060 | WI | Primary |
Addresses
Primary practice location
1211 Rickmeyer Dr
Suite CC
Fond Du Lac, WI 54937-2213
Mailing address
140 Corporate Dr
Suite 1
Beaver Dam, WI 53916-1281
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42834900 | Medicaid | WI |
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 |
|---|---|---|---|
| 1183-060 | WI | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1376731018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 CORPORATE DR",
"address_2": "SUITE 1",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539161281",
"fax_number": "920-887-9655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 RICKMEYER DR",
"address_2": "SUITE CC",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549372213",
"telephone_number": "920-922-6640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELLMER",
"first_name": "MATT",
"credential": "H.I.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-09",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WI",
"license": "1183-060",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42834900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.