Active NPI
John W Dykstra, H.I.S.
- Hearing Instrument Specialist
- New Berlin, WI
National Provider Identifier
1417329772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 1287
- Practice address
- 3333 S Sunnyslope Rd
Suite 102
New Berlin, WI 53151-4502 - Phone
- (262) 784-0236
- Fax
- (262) 784-0237
- NPI assigned
- Oct 27, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 1287 | WI | Primary |
Addresses
Primary practice location
3333 S Sunnyslope Rd
Suite 102
New Berlin, WI 53151-4502
Mailing address
5200 Washington Ave
Suite 102
Racine, WI 53406-4238
Phone (262) 637-5668
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 |
|---|---|---|---|
| 1287 | WI | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Wisconsin Hearing, LLC | 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.
-
- Hearing Aid Equipment
- Racine, WI
- NPI 1063716165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445904000000",
"number": "1417329772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 WASHINGTON AVE",
"address_2": "SUITE 102",
"city": "RACINE",
"state": "WI",
"postal_code": "534064238",
"telephone_number": "262-637-5668",
"fax_number": "262-637-5009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 S SUNNYSLOPE RD",
"address_2": "SUITE 102",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531514502",
"telephone_number": "262-784-0236",
"fax_number": "262-784-0237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYKSTRA",
"first_name": "JOHN",
"middle_name": "W",
"credential": "H.I.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-27",
"last_updated": "2015-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WI",
"license": "1287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.