Organization Active NPI

Rocky Mountain Urology,LLC

  • Pediatric Urology Physician
  • Columbus, WI
National Provider Identifier
1689871451
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
License
7089 Issued in MT
Legal business name
ROCKY MOUNTAIN UROLOGY,LLC
Practice address
1511 Park Ave
Suite F
Columbus, WI 53925-2401
Phone
(920) 623-9970
Fax
(920) 623-9970
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Michael Ervin Kuglitsch, MD
Title
Owner
Phone
(920) 623-9970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2088P0231X 7089 MT Primary

Addresses

Primary practice location

1511 Park Ave
Suite F
Columbus, WI 53925-2401

Mailing address

1511 Park Ave
Suite F
Columbus, WI 53925-2401
Phone (920) 623-9970

Other identifiers 6

IdentifierTypeStateIssuer
0020103002MedicaidID
8N223OtherIDBC IDAHO
000010154126OtherIDREGENCY BLUE SHIELD OF ID
DB7643OtherMTRAILROAD MEDICARE
0081226MedicaidMT
30673100MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1689871451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 PARK AVE",
            "address_2": "SUITE F",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539252401",
            "telephone_number": "920-623-9970",
            "fax_number": "920-623-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 PARK AVE",
            "address_2": "SUITE F",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539252401",
            "telephone_number": "920-623-9970",
            "fax_number": "920-623-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN UROLOGY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "KUGLITSCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ERVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-623-9970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": "MT",
            "license": "7089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0020103002",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC IDAHO",
            "identifier": "8N223",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCY BLUE SHIELD OF ID",
            "identifier": "000010154126",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB7643",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081226",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30673100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.

Verify at the official NPI Registry.