Active NPI
Catie Fern Pontel, PTA
- Health Maintenance Organization
- Walworth, WI
National Provider Identifier
1396010468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- 1652-019
- Practice address
- 270 Ridge Rd
Walworth, WI 53184-9526 - Phone
- (262) 275-2317
- NPI assigned
- Mar 21, 2012
- Last updated
- Aug 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | 1652-019 | WI | Primary |
Addresses
Primary practice location
270 Ridge Rd
Walworth, WI 53184-9526
Mailing address
W4929 Paddock Dr
Elkhorn, WI 53121-3106
Phone (414) 687-9526
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 |
|---|---|---|---|
| 1652-019 | WI | MD | Health Maintenance Organization |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346025600000",
"number": "1396010468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W4929 PADDOCK DR",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531213106",
"telephone_number": "414-687-9526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 RIDGE RD",
"city": "WALWORTH",
"state": "WI",
"postal_code": "531849526",
"telephone_number": "262-275-2317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONTEL",
"first_name": "CATIE",
"middle_name": "FERN",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-21",
"last_updated": "2012-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "WI",
"license": "1652-019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walworth, WI
- Victoria Ann Knull, RN
- Bridget Grace Labus, DC
- Lake Geneva Psychology, Inc.
- McCullough Pharmacy Inc (McCulloughs Prescription and Gifts)
- Michael C. Nice, D.C.
- Powerback Rehabilitation LLC (Powerback Rehabilitation)
- Daniel William Rankin
- Lindsey E Tuntland, MD
- Jennifer L Van Vleet, RN
- Village of Walworth (Walworth Fire & Rescue)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.