Bart L Mengo

Primary specialty

ContractorTaxonomy code 171W00000X

License

1185780 Issued in WI

Practice address

1715 60TH Street
Kenosha, WI 53140

Phone

(262) 496-1333

Fax

(262) 657-0244

NPI assigned

May 30, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1659863389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 60TH STREET",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53140",
            "telephone_number": "262-496-1333",
            "fax_number": "262-657-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 60TH STREET",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53140",
            "telephone_number": "262-496-1333",
            "fax_number": "262-657-0244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1715 60th street",
            "address_purpose": "LOCATION",
            "city": "kenosha",
            "state": "WI",
            "postal_code": "53140",
            "country_code": "US",
            "telephone_number": "262-496-1333",
            "fax_number": "262-657-0244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENGO",
        "first_name": "BART",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "WI",
            "license": "1185780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Mehring, FNP-C
• Meijer Stores Limited Partnership
• Stella Viktorivna Meinert, PTA
• Sarah Anita Melton
• Precious Mendoza, RN
• Elizabeth Mentink, LPC-IT
• Cristina Mercado Navarro
• Katie Lynn Merges, LPC-IT
• Dana Merkel, DPT
• Ashley Mermolia, LAT, ATC

• Contractor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Contractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.