Fairway Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FAIRWAY MEDICAL LLC

Practice address

W67N222 Evergreen Blvd Ste 218
Cedarburg, WI 53012-2650

Phone

(262) 519-7319

Fax

(262) 450-4056

NPI assigned

Jul 31, 2024

Organization subpart

No

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

Authorized official

Name

David Arthur Scottberg

Title

Co-Owner

Phone

(262) 518-7319

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1679302228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W67N222 EVERGREEN BLVD STE 218",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122650",
            "telephone_number": "262-518-7319",
            "fax_number": "262-450-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W67N222 EVERGREEN BLVD STE 218",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122650",
            "telephone_number": "262-519-7319",
            "fax_number": "262-450-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWAY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "SCOTTBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "262-518-7319"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Cedarburg, WI
• Providers in Cedarburg, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.