Active NPI
Joe G Prell, O.D.
- Optometrist
- Reedsburg, WI
National Provider Identifier
1619002243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1640
- Practice address
- 251 2ND St
Reedsburg, WI 53959-1610 - Phone
- (608) 524-4334
- Fax
- (608) 524-4335
- NPI assigned
- Feb 22, 2007
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1640 | WI | Primary |
Addresses
Primary practice location
251 2ND St
Reedsburg, WI 53959-1610
Mailing address
PO Box 309
Reedsburg, WI 53959-0309
Phone (608) 524-4334
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38506100 | Medicaid | WI |
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 |
|---|---|---|---|
| 1640 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227052800000",
"number": "1619002243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 309",
"city": "REEDSBURG",
"state": "WI",
"postal_code": "539590309",
"telephone_number": "608-524-4334",
"fax_number": "608-524-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 2ND ST",
"city": "REEDSBURG",
"state": "WI",
"postal_code": "539591610",
"telephone_number": "608-524-4334",
"fax_number": "608-524-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRELL",
"first_name": "JOE",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2008-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "1640",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38506100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reedsburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.