Active NPI
John A Mortensen
- Audiologist
- West Allis, WI
National Provider Identifier
1407802564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 365-156
- Practice address
- 2255 S 108TH St
West Allis, WI 53227-1107 - Phone
- (414) 774-4200
- Fax
- (414) 774-6828
- NPI assigned
- May 26, 2006
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 365-156 | WI | Primary |
Addresses
Primary practice location
2255 S 108TH St
West Allis, WI 53227-1107
Mailing address
2255 S 108TH St
West Allis, WI 53227-1107
Phone (414) 774-4200
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 365-156 | WI | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonus-USA, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Audiologist-Hearing Aid Fitter
- Eugene, OR
- NPI 1780765099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400803200000",
"number": "1407802564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2255 S 108TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532271107",
"telephone_number": "414-774-4200",
"fax_number": "414-774-6828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2255 S 108TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532271107",
"telephone_number": "414-774-4200",
"fax_number": "414-774-6828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSEN",
"first_name": "JOHN",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2014-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WI",
"license": "365-156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.