Individual provider Active NPI

Paul Mross

  • Contractor
  • Belleville, WI
National Provider Identifier
1477935583
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
783-146 Issued in WI
Practice address
8331 Community Rd
Belleville, WI 53508-9563
Phone
(608) 469-5784
NPI assigned
Jun 25, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 783-146 WI Primary

Addresses

Primary practice location

8331 Community Rd
Belleville, WI 53508-9563

Mailing address

8331 Community Rd
Belleville, WI 53508-9563
Phone (608) 469-5784

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

LicenseStateTypeSpecialty
783-146WIMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1477935583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8331 COMMUNITY RD",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089563",
            "telephone_number": "608-469-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8331 COMMUNITY RD",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089563",
            "telephone_number": "608-469-5784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MROSS",
        "first_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "WI",
            "license": "783-146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.