Individual provider Active NPI

Jory A Ough, M.D.

  • Obstetrics & Gynecology Physician
  • Green Bay, WI
National Provider Identifier
1457518532
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
55684-020 Issued in WI
Practice address
2641 Development Dr
Green Bay, WI 54311-4240
Phone
(920) 338-6868
Fax
(920) 338-6869
NPI assigned
May 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 125-051116 IL
Obstetrics & Gynecology Physician 207V00000X 55684-020 WI Primary

Addresses

Primary practice location

2641 Development Dr
Green Bay, WI 54311-4240

Mailing address

2641 Development Dr
Green Bay, WI 54311-4240
Phone (920) 338-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110708000504 WI Practitioner - Obstetrics/Gynecology 5092993329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125-051116ILMDObstetrics & Gynecology Physician
55684-020WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Sep 5, 2017 Accepting new patients
Bellin Memorial Hospital Inc Obstetrics & Gynecology CurrentSince Sep 5, 2017 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2641 Development Dr
Green Bay, WI 54311

Interoperability endpoints

  • Direct secure messaging: jough42021@direct.thedacare.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1210982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1457518532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 DEVELOPMENT DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114240",
            "telephone_number": "920-338-6868",
            "fax_number": "920-338-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 DEVELOPMENT DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114240",
            "telephone_number": "920-338-6868",
            "fax_number": "920-338-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUGH",
        "first_name": "JORY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-17",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125-051116",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "55684-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.