CDK Residentials, LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

K4006417318200 Issued in WI

Legal business name

CDK RESIDENTIALS, LLC

Practice address

4856 N 40TH St
Milwaukee, WI 53209-5204

Phone

(414) 759-2276

NPI assigned

Oct 3, 2017

Last updated

Oct 3, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Orin A Kelly Sr.NPI 1801306998

Title

Proprietor

Phone

(414) 759-2276

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Orin A Kelly Sr.

  • Non-emergency Medical Transport (VAN)
  • Milwaukee, WI
  • NPI 1801306998
  NPD (past) Authorized official

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1487164562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 N 40TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532095204",
            "telephone_number": "414-759-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4856 N 40TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532095204",
            "telephone_number": "414-759-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDK RESIDENTIALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ORIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "414-759-2276",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "WI",
            "license": "K4006417318200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Non-emergency Medical Transport (VAN) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.